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 $1,202.26 Median $6,456.54 Typical High $13,803.84 | Facility | None | $1,202.26 | $6,456.54 | $13,803.84 |
Aetna Setting Professional Modifier None Typical Low $1,047.13 Median $1,202.26 Typical High $1,348.96 | Professional | None | $1,047.13 | $1,202.26 | $1,348.96 |
AvMed Setting Facility Modifier None Typical Low $1,000.00 Median $4,365.16 Typical High $13,182.57 | Facility | None | $1,000.00 | $4,365.16 | $13,182.57 |
AvMed Setting Professional Modifier None Typical Low $1,000.00 Median $1,258.93 Typical High $1,479.11 | Professional | None | $1,000.00 | $1,258.93 | $1,479.11 |
Cigna Setting Facility Modifier None Typical Low $537.03 Median $5,495.41 Typical High $11,481.54 | Facility | None | $537.03 | $5,495.41 | $11,481.54 |
Cigna Setting Professional Modifier None Typical Low $933.25 Median $1,000.00 Typical High $1,778.28 | Professional | None | $933.25 | $1,000.00 | $1,778.28 |
Florida Blue Setting Facility Modifier None Typical Low $2,818.38 Median $5,495.41 Typical High $16,982.44 | Facility | None | $2,818.38 | $5,495.41 | $16,982.44 |
Florida Blue Setting Professional Modifier None Typical Low $602.56 Median $1,148.15 Typical High $1,479.11 | Professional | None | $602.56 | $1,148.15 | $1,479.11 |
Molina Setting Professional Modifier None Typical Low $87.10 Median $831.76 Typical High $1,995.26 | Professional | None | $87.10 | $831.76 | $1,995.26 |
United Setting Facility Modifier None Typical Low $2,511.89 Median $10,000.00 Typical High $19,498.45 | Facility | None | $2,511.89 | $10,000.00 | $19,498.45 |
United Setting Professional Modifier None Typical Low $891.25 Median $1,148.15 Typical High $1,862.09 | Professional | None | $891.25 | $1,148.15 | $1,862.09 |
Wellpoint Setting Professional Modifier None Typical Low $912.01 Median $912.01 Typical High $912.01 | Professional | None | $912.01 | $912.01 | $912.01 |
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 $524.81 Median $602.56 Typical High $676.08 | Professional | 52 · Reduced service | $524.81 | $602.56 | $676.08 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $208.93 Median $239.88 Typical High $269.15 | Professional | 53 · Discontinued | $208.93 | $239.88 | $269.15 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $794.33 Median $912.01 Typical High $1,000.00 | Professional | 54 · Surgery only | $794.33 | $912.01 | $1,000.00 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $158.49 Median $181.97 Typical High $204.17 | Professional | 55 · Aftercare only | $158.49 | $181.97 | $204.17 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $104.71 Median $120.23 Typical High $134.90 | Professional | 56 · Pre-op care only | $104.71 | $120.23 | $134.90 |
Aetna Setting Professional Modifier 78 · Unplanned return to OR Typical Low $741.31 Median $851.14 Typical High $933.25 | Professional | 78 · Unplanned return to OR | $741.31 | $851.14 | $933.25 |
Where Florida sits
The same service costs 25.7 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
$1,000
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.