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 $1,122.02 Median $1,318.26 Typical High $1,479.11 | Professional | None | $1,122.02 | $1,318.26 | $1,479.11 |
AvMed Setting Facility Modifier None Typical Low $1,096.48 Median $2,137.96 Typical High $11,748.98 | Facility | None | $1,096.48 | $2,137.96 | $11,748.98 |
AvMed Setting Professional Modifier None Typical Low $1,096.48 Median $1,318.26 Typical High $1,584.89 | Professional | None | $1,096.48 | $1,318.26 | $1,584.89 |
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 $1,000.00 Median $1,071.52 Typical High $1,905.46 | Professional | None | $1,000.00 | $1,071.52 | $1,905.46 |
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 $645.65 Median $1,096.48 Typical High $1,584.89 | Professional | None | $645.65 | $1,096.48 | $1,584.89 |
Molina Setting Professional Modifier None Typical Low $128.82 Median $1,023.29 Typical High $2,344.23 | Professional | None | $128.82 | $1,023.29 | $2,344.23 |
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 $954.99 Median $1,202.26 Typical High $1,995.26 | Professional | None | $954.99 | $1,202.26 | $1,995.26 |
Wellpoint Setting Professional Modifier None Typical Low $1,000.00 Median $1,000.00 Typical High $1,000.00 | Professional | None | $1,000.00 | $1,000.00 | $1,000.00 |
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 $562.34 Median $660.69 Typical High $741.31 | Professional | 52 · Reduced service | $562.34 | $660.69 | $741.31 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $223.87 Median $263.03 Typical High $295.12 | Professional | 53 · Discontinued | $223.87 | $263.03 | $295.12 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $831.76 Median $1,000.00 Typical High $1,096.48 | Professional | 54 · Surgery only | $831.76 | $1,000.00 | $1,096.48 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $165.96 Median $199.53 Typical High $218.78 | Professional | 55 · Aftercare only | $165.96 | $199.53 | $218.78 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $112.20 Median $131.83 Typical High $147.91 | Professional | 56 · Pre-op care only | $112.20 | $131.83 | $147.91 |
Aetna Setting Professional Modifier 78 · Unplanned return to OR Typical Low $776.25 Median $933.25 Typical High $1,023.29 | Professional | 78 · Unplanned return to OR | $776.25 | $933.25 | $1,023.29 |
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· 49th of 51
$1,122
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.