How much rates vary
Distribution of negotiated rates across all payers (price axis is log-scale). Need provider-level prices or 24+ months of history? Contact us.
Rates by insurance carrier
| Insurance Carrier | Facility/Professional | Modifier | Typical Low | Median | Typical High |
|---|---|---|---|---|---|
Aetna Setting Facility Modifier None Typical Low $1,445.44 Median $5,011.87 Typical High $24,547.09 | Facility | None | $1,445.44 | $5,011.87 | $24,547.09 |
Aetna Setting Professional Modifier None Typical Low $1,479.11 Median $1,737.80 Typical High $1,949.84 | Professional | None | $1,479.11 | $1,737.80 | $1,949.84 |
AvMed Setting Facility Modifier None Typical Low $1,445.44 Median $2,137.96 Typical High $13,182.57 | Facility | None | $1,445.44 | $2,137.96 | $13,182.57 |
AvMed Setting Professional Modifier None Typical Low $1,445.44 Median $1,778.28 Typical High $2,089.30 | Professional | None | $1,445.44 | $1,778.28 | $2,089.30 |
Cigna Setting Facility Modifier None Typical Low $398.11 Median $562.34 Typical High $28,183.83 | Facility | None | $398.11 | $562.34 | $28,183.83 |
Cigna Setting Professional Modifier None Typical Low $1,348.96 Median $1,412.54 Typical High $2,511.89 | Professional | None | $1,348.96 | $1,412.54 | $2,511.89 |
Florida Blue Setting Facility Modifier None Typical Low $10,471.29 Median $22,387.21 Typical High $33,884.42 | Facility | None | $10,471.29 | $22,387.21 | $33,884.42 |
Florida Blue Setting Professional Modifier None Typical Low $870.96 Median $1,479.11 Typical High $2,089.30 | Professional | None | $870.96 | $1,479.11 | $2,089.30 |
Molina Setting Professional Modifier None Typical Low $208.93 Median $1,737.80 Typical High $3,467.37 | Professional | None | $208.93 | $1,737.80 | $3,467.37 |
United Setting Facility Modifier None Typical Low $371.54 Median $954.99 Typical High $7,585.78 | Facility | None | $371.54 | $954.99 | $7,585.78 |
United Setting Professional Modifier None Typical Low $1,288.25 Median $1,621.81 Typical High $2,691.53 | Professional | None | $1,288.25 | $1,621.81 | $2,691.53 |
Wellpoint Setting Professional Modifier None Typical Low $1,318.26 Median $1,318.26 Typical High $1,318.26 | Professional | None | $1,318.26 | $1,318.26 | $1,318.26 |
6 more rates with less common billing modifiers
A modifier changes what was billed, for example a reduced or repeated service. Each of these modifiers carries under 10% of the published rates for this code. Modifier combinations, and modifiers with fewer than 30 rates for a carrier, are not listed.
| Insurance Carrier | Facility/Professional | Modifier | Typical Low | Median | Typical High |
|---|---|---|---|---|---|
Aetna Setting Professional Modifier 52 · Reduced service Typical Low $741.31 Median $870.96 Typical High $954.99 | Professional | 52 · Reduced service | $741.31 | $870.96 | $954.99 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $295.12 Median $346.74 Typical High $389.05 | Professional | 53 · Discontinued | $295.12 | $346.74 | $389.05 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $1,122.02 Median $1,288.25 Typical High $1,445.44 | Professional | 54 · Surgery only | $1,122.02 | $1,288.25 | $1,445.44 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $223.87 Median $257.04 Typical High $288.40 | Professional | 55 · Aftercare only | $223.87 | $257.04 | $288.40 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $147.91 Median $173.78 Typical High $194.98 | Professional | 56 · Pre-op care only | $147.91 | $173.78 | $194.98 |
Aetna Setting Professional Modifier 78 · Unplanned return to OR Typical Low $1,047.13 Median $1,202.26 Typical High $1,348.96 | Professional | 78 · Unplanned return to OR | $1,047.13 | $1,202.26 | $1,348.96 |
Where Florida sits
The same service costs 5.4 times more in Alaska than in Texas. Every bar is a state, most expensive first. Touch or drag across it to read any state, then open that state for its carriers and full range.
Florida· 48th of 51
$1,622
Median negotiated rate in each state, from every insurer that publishes one. States where no insurer publishes a rate for this service are not shown.