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 $1,621.81 Median $2,041.74 Typical High $2,570.40 | Professional | None | $1,621.81 | $2,041.74 | $2,570.40 |
AvMed Setting Facility Modifier None Typical Low $1,445.44 Median $2,454.71 Typical High $11,748.98 | Facility | None | $1,445.44 | $2,454.71 | $11,748.98 |
AvMed Setting Professional Modifier None Typical Low $1,819.70 Median $2,238.72 Typical High $2,754.23 | Professional | None | $1,819.70 | $2,238.72 | $2,754.23 |
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 $1,659.59 Median $2,137.96 Typical High $4,365.16 | Professional | None | $1,659.59 | $2,137.96 | $4,365.16 |
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 $1,445.44 Median $1,698.24 Typical High $2,137.96 | Professional | None | $1,445.44 | $1,698.24 | $2,137.96 |
Molina Setting Professional Modifier None Typical Low $223.87 Median $1,659.59 Typical High $3,467.37 | Professional | None | $223.87 | $1,659.59 | $3,467.37 |
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 $2,398.83 Typical High $4,786.30 | Professional | None | $60.26 | $2,398.83 | $4,786.30 |
Wellpoint Setting Professional Modifier None Typical Low $1,621.81 Median $1,621.81 Typical High $2,238.72 | Professional | None | $1,621.81 | $1,621.81 | $2,238.72 |
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 $794.33 Median $1,023.29 Typical High $1,202.26 | Professional | 52 · Reduced service | $794.33 | $1,023.29 | $1,202.26 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $323.59 Median $407.38 Typical High $478.63 | Professional | 53 · Discontinued | $323.59 | $407.38 | $478.63 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $1,202.26 Median $1,513.56 Typical High $1,819.70 | Professional | 54 · Surgery only | $1,202.26 | $1,513.56 | $1,819.70 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $239.88 Median $302.00 Typical High $363.08 | Professional | 55 · Aftercare only | $239.88 | $302.00 | $363.08 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $162.18 Median $204.17 Typical High $239.88 | Professional | 56 · Pre-op care only | $162.18 | $204.17 | $239.88 |
Aetna Setting Professional Modifier 78 · Unplanned return to OR Typical Low $1,122.02 Median $1,412.54 Typical High $1,698.24 | Professional | 78 · Unplanned return to OR | $1,122.02 | $1,412.54 | $1,698.24 |
Where Florida sits
The same service costs 8.1 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· 47th of 51
$1,905
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.