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 $4,786.30 Typical High $11,748.98 | Facility | None | $776.25 | $4,786.30 | $11,748.98 |
Aetna Setting Professional Modifier None Typical Low $1,258.93 Median $1,258.93 Typical High $1,698.24 | Professional | None | $1,258.93 | $1,258.93 | $1,698.24 |
Ambetter Setting Professional Modifier None Typical Low $1,737.80 Median $1,737.80 Typical High $1,737.80 | Professional | None | $1,737.80 | $1,737.80 | $1,737.80 |
AvMed Setting Facility Modifier None Typical Low $912.01 Median $2,137.96 Typical High $9,772.37 | Facility | None | $912.01 | $2,137.96 | $9,772.37 |
AvMed Setting Professional Modifier None Typical Low $1,071.52 Median $1,445.44 Typical High $1,621.81 | Professional | None | $1,071.52 | $1,445.44 | $1,621.81 |
Cigna Setting Facility Modifier None Typical Low $501.19 Median $2,691.53 Typical High $4,786.30 | Facility | None | $501.19 | $2,691.53 | $4,786.30 |
Cigna Setting Professional Modifier None Typical Low $1,000.00 Median $1,412.54 Typical High $2,818.38 | Professional | None | $1,000.00 | $1,412.54 | $2,818.38 |
Florida Blue Setting Facility Modifier None Typical Low $1,318.26 Median $2,630.27 Typical High $16,982.44 | Facility | None | $1,318.26 | $2,630.27 | $16,982.44 |
Florida Blue Setting Professional Modifier None Typical Low $912.01 Median $977.24 Typical High $1,659.59 | Professional | None | $912.01 | $977.24 | $1,659.59 |
Molina Setting Professional Modifier None Typical Low $141.25 Median $1,148.15 Typical High $2,290.87 | Professional | None | $141.25 | $1,148.15 | $2,290.87 |
United Setting Facility Modifier None Typical Low $1,230.27 Median $3,311.31 Typical High $12,589.25 | Facility | None | $1,230.27 | $3,311.31 | $12,589.25 |
United Setting Professional Modifier None Typical Low $60.26 Median $1,584.89 Typical High $2,951.21 | Professional | None | $60.26 | $1,584.89 | $2,951.21 |
Wellpoint Setting Professional Modifier None Typical Low $977.24 Median $977.24 Typical High $1,288.25 | Professional | None | $977.24 | $977.24 | $1,288.25 |
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 $616.60 Median $630.96 Typical High $831.76 | Professional | 52 · Reduced service | $616.60 | $630.96 | $831.76 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $251.19 Median $251.19 Typical High $331.13 | Professional | 53 · Discontinued | $251.19 | $251.19 | $331.13 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $933.25 Median $933.25 Typical High $1,258.93 | Professional | 54 · Surgery only | $933.25 | $933.25 | $1,258.93 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $186.21 Median $186.21 Typical High $251.19 | Professional | 55 · Aftercare only | $186.21 | $186.21 | $251.19 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $125.89 Median $125.89 Typical High $165.96 | Professional | 56 · Pre-op care only | $125.89 | $125.89 | $165.96 |
Aetna Setting Professional Modifier 78 · Unplanned return to OR Typical Low $870.96 Median $870.96 Typical High $1,174.90 | Professional | 78 · Unplanned return to OR | $870.96 | $870.96 | $1,174.90 |
Where Florida sits
The same service costs 5.8 times more in Alaska than in Utah. 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
$1,413
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.