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 $776.25 Median $3,890.45 Typical High $12,022.64 | Facility | None | $776.25 | $3,890.45 | $12,022.64 |
Aetna Setting Professional Modifier None Typical Low $1,174.90 Median $1,380.38 Typical High $1,548.82 | Professional | None | $1,174.90 | $1,380.38 | $1,548.82 |
AvMed Setting Facility Modifier None Typical Low $1,122.02 Median $2,137.96 Typical High $11,748.98 | Facility | None | $1,122.02 | $2,137.96 | $11,748.98 |
AvMed Setting Professional Modifier None Typical Low $1,122.02 Median $1,348.96 Typical High $1,659.59 | Professional | None | $1,122.02 | $1,348.96 | $1,659.59 |
Cigna Setting Facility Modifier None Typical Low $398.11 Median $501.19 Typical High $2,691.53 | Facility | None | $398.11 | $501.19 | $2,691.53 |
Cigna Setting Professional Modifier None Typical Low $1,047.13 Median $1,122.02 Typical High $1,995.26 | Professional | None | $1,047.13 | $1,122.02 | $1,995.26 |
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 $676.08 Median $1,122.02 Typical High $1,659.59 | Professional | None | $676.08 | $1,122.02 | $1,659.59 |
Molina Setting Professional Modifier None Typical Low $128.82 Median $1,071.52 Typical High $2,454.71 | Professional | None | $128.82 | $1,071.52 | $2,454.71 |
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 $1,000.00 Median $1,258.93 Typical High $2,089.30 | Professional | None | $1,000.00 | $1,258.93 | $2,089.30 |
Wellpoint Setting Professional Modifier None Typical Low $1,023.29 Median $1,023.29 Typical High $1,023.29 | Professional | None | $1,023.29 | $1,023.29 | $1,023.29 |
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 $588.84 Median $691.83 Typical High $776.25 | Professional | 52 · Reduced service | $588.84 | $691.83 | $776.25 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $234.42 Median $275.42 Typical High $309.03 | Professional | 53 · Discontinued | $234.42 | $275.42 | $309.03 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $870.96 Median $1,047.13 Typical High $1,148.15 | Professional | 54 · Surgery only | $870.96 | $1,047.13 | $1,148.15 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $173.78 Median $208.93 Typical High $229.09 | Professional | 55 · Aftercare only | $173.78 | $208.93 | $229.09 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $117.49 Median $138.04 Typical High $154.88 | Professional | 56 · Pre-op care only | $117.49 | $138.04 | $154.88 |
Aetna Setting Professional Modifier 78 · Unplanned return to OR Typical Low $812.83 Median $977.24 Typical High $1,071.52 | Professional | 78 · Unplanned return to OR | $812.83 | $977.24 | $1,071.52 |
Where Florida sits
The same service costs 5.2 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· 49th of 51
$1,175
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.