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 $3,467.37 Median $3,890.45 Typical High $4,570.88 | Professional | None | $3,467.37 | $3,890.45 | $4,570.88 |
AvMed Setting Facility Modifier None Typical Low $1,445.44 Median $4,073.80 Typical High $11,748.98 | Facility | None | $1,445.44 | $4,073.80 | $11,748.98 |
AvMed Setting Professional Modifier None Typical Low $3,548.13 Median $4,365.16 Typical High $5,248.07 | Professional | None | $3,548.13 | $4,365.16 | $5,248.07 |
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 $3,090.30 Median $4,168.69 Typical High $8,511.38 | Professional | None | $3,090.30 | $4,168.69 | $8,511.38 |
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 $2,951.21 Median $3,162.28 Typical High $4,365.16 | Professional | None | $2,951.21 | $3,162.28 | $4,365.16 |
Molina Setting Professional Modifier None Typical Low $436.52 Median $3,019.95 Typical High $6,309.57 | Professional | None | $436.52 | $3,019.95 | $6,309.57 |
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 $4,677.35 Typical High $8,912.51 | Professional | None | $60.26 | $4,677.35 | $8,912.51 |
Wellpoint Setting Professional Modifier None Typical Low $2,951.21 Median $2,951.21 Typical High $4,168.69 | Professional | None | $2,951.21 | $2,951.21 | $4,168.69 |
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 $1,737.80 Median $1,905.46 Typical High $2,238.72 | Professional | 52 · Reduced service | $1,737.80 | $1,905.46 | $2,238.72 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $691.83 Median $776.25 Typical High $912.01 | Professional | 53 · Discontinued | $691.83 | $776.25 | $912.01 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $2,570.40 Median $2,884.03 Typical High $3,388.44 | Professional | 54 · Surgery only | $2,570.40 | $2,884.03 | $3,388.44 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $512.86 Median $575.44 Typical High $676.08 | Professional | 55 · Aftercare only | $512.86 | $575.44 | $676.08 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $346.74 Median $389.05 Typical High $457.09 | Professional | 56 · Pre-op care only | $346.74 | $389.05 | $457.09 |
Aetna Setting Professional Modifier 78 · Unplanned return to OR Typical Low $2,398.83 Median $2,691.53 Typical High $3,162.28 | Professional | 78 · Unplanned return to OR | $2,398.83 | $2,691.53 | $3,162.28 |
Where Florida sits
The same service costs 21.4 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· 48th of 51
$3,388
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.