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 $3,801.89 Typical High $12,022.64 | Facility | None | $776.25 | $3,801.89 | $12,022.64 |
Aetna Setting Professional Modifier None Typical Low $1,621.81 Median $2,137.96 Typical High $2,884.03 | Professional | None | $1,621.81 | $2,137.96 | $2,884.03 |
AvMed Setting Facility Modifier None Typical Low $1,445.44 Median $2,570.40 Typical High $11,748.98 | Facility | None | $1,445.44 | $2,570.40 | $11,748.98 |
AvMed Setting Professional Modifier None Typical Low $2,041.74 Median $2,511.89 Typical High $3,090.30 | Professional | None | $2,041.74 | $2,511.89 | $3,090.30 |
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 $1,819.70 Median $2,344.23 Typical High $4,786.30 | Professional | None | $1,819.70 | $2,344.23 | $4,786.30 |
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 $1,412.54 Median $1,905.46 Typical High $2,454.71 | Professional | None | $1,412.54 | $1,905.46 | $2,454.71 |
Molina Setting Professional Modifier None Typical Low $331.13 Median $2,137.96 Typical High $4,168.69 | Professional | None | $331.13 | $2,137.96 | $4,168.69 |
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 $2,754.23 Typical High $5,248.07 | Professional | None | $60.26 | $2,754.23 | $5,248.07 |
Wellpoint Setting Professional Modifier None Typical Low $1,819.70 Median $1,819.70 Typical High $2,570.40 | Professional | None | $1,819.70 | $1,819.70 | $2,570.40 |
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 $812.83 Median $1,071.52 Typical High $1,348.96 | Professional | 52 · Reduced service | $812.83 | $1,071.52 | $1,348.96 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $323.59 Median $426.58 Typical High $537.03 | Professional | 53 · Discontinued | $323.59 | $426.58 | $537.03 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $1,230.27 Median $1,621.81 Typical High $1,995.26 | Professional | 54 · Surgery only | $1,230.27 | $1,621.81 | $1,995.26 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $245.47 Median $323.59 Typical High $407.38 | Professional | 55 · Aftercare only | $245.47 | $323.59 | $407.38 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $162.18 Median $213.80 Typical High $269.15 | Professional | 56 · Pre-op care only | $162.18 | $213.80 | $269.15 |
Aetna Setting Professional Modifier 78 · Unplanned return to OR Typical Low $1,148.15 Median $1,513.56 Typical High $1,862.09 | Professional | 78 · Unplanned return to OR | $1,148.15 | $1,513.56 | $1,862.09 |
Where Florida sits
The same service costs 6.0 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
$2,188
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.