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 $2,754.23 Median $3,090.30 Typical High $3,715.35 | Professional | None | $2,754.23 | $3,090.30 | $3,715.35 |
AvMed Setting Facility Modifier None Typical Low $1,445.44 Median $3,235.94 Typical High $11,748.98 | Facility | None | $1,445.44 | $3,235.94 | $11,748.98 |
AvMed Setting Professional Modifier None Typical Low $2,884.03 Median $3,467.37 Typical High $4,073.80 | Professional | None | $2,884.03 | $3,467.37 | $4,073.80 |
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 $2,454.71 Median $3,311.31 Typical High $6,606.93 | Professional | None | $2,454.71 | $3,311.31 | $6,606.93 |
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 $2,344.23 Median $2,511.89 Typical High $3,467.37 | Professional | None | $2,344.23 | $2,511.89 | $3,467.37 |
Molina Setting Professional Modifier None Typical Low $354.81 Median $2,454.71 Typical High $5,128.61 | Professional | None | $354.81 | $2,454.71 | $5,128.61 |
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 $60.26 Median $3,715.35 Typical High $7,079.46 | Professional | None | $60.26 | $3,715.35 | $7,079.46 |
Wellpoint Setting Professional Modifier None Typical Low $2,398.83 Median $2,398.83 Typical High $3,311.31 | Professional | None | $2,398.83 | $2,398.83 | $3,311.31 |
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 $1,380.38 Median $1,548.82 Typical High $1,778.28 | Professional | 52 · Reduced service | $1,380.38 | $1,548.82 | $1,778.28 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $549.54 Median $616.60 Typical High $724.44 | Professional | 53 · Discontinued | $549.54 | $616.60 | $724.44 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $2,041.74 Median $2,290.87 Typical High $2,691.53 | Professional | 54 · Surgery only | $2,041.74 | $2,290.87 | $2,691.53 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $407.38 Median $457.09 Typical High $537.03 | Professional | 55 · Aftercare only | $407.38 | $457.09 | $537.03 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $275.42 Median $309.03 Typical High $354.81 | Professional | 56 · Pre-op care only | $275.42 | $309.03 | $354.81 |
Aetna Setting Professional Modifier 78 · Unplanned return to OR Typical Low $1,905.46 Median $2,137.96 Typical High $2,511.89 | Professional | 78 · Unplanned return to OR | $1,905.46 | $2,137.96 | $2,511.89 |
Where Florida sits
The same service costs 18.2 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· 48th of 51
$2,754
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.