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 $1,819.70 Typical High $2,187.76 | Professional | None | $1,621.81 | $1,819.70 | $2,187.76 |
AvMed Setting Facility Modifier None Typical Low $1,445.44 Median $2,187.76 Typical High $11,748.98 | Facility | None | $1,445.44 | $2,187.76 | $11,748.98 |
AvMed Setting Professional Modifier None Typical Low $1,621.81 Median $2,089.30 Typical High $2,454.71 | Professional | None | $1,621.81 | $2,089.30 | $2,454.71 |
Cigna Setting Facility Modifier None Typical Low $398.11 Median $1,202.26 Typical High $6,760.83 | Facility | None | $398.11 | $1,202.26 | $6,760.83 |
Cigna Setting Professional Modifier None Typical Low $1,445.44 Median $1,584.89 Typical High $3,090.30 | Professional | None | $1,445.44 | $1,584.89 | $3,090.30 |
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 $831.76 Median $1,778.28 Typical High $2,187.76 | Professional | None | $831.76 | $1,778.28 | $2,187.76 |
Molina Setting Professional Modifier None Typical Low $199.53 Median $1,584.89 Typical High $2,570.40 | Professional | None | $199.53 | $1,584.89 | $2,570.40 |
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 $1,288.25 Median $1,698.24 Typical High $3,388.44 | Professional | None | $1,288.25 | $1,698.24 | $3,388.44 |
Wellpoint Setting Professional Modifier None Typical Low $1,445.44 Median $1,445.44 Typical High $2,041.74 | Professional | None | $1,445.44 | $1,445.44 | $2,041.74 |
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 $912.01 Typical High $1,071.52 | Professional | 52 · Reduced service | $812.83 | $912.01 | $1,071.52 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $323.59 Median $363.08 Typical High $426.58 | Professional | 53 · Discontinued | $323.59 | $363.08 | $426.58 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $1,202.26 Median $1,380.38 Typical High $1,584.89 | Professional | 54 · Surgery only | $1,202.26 | $1,380.38 | $1,584.89 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $239.88 Median $275.42 Typical High $323.59 | Professional | 55 · Aftercare only | $239.88 | $275.42 | $323.59 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $162.18 Median $181.97 Typical High $213.80 | Professional | 56 · Pre-op care only | $162.18 | $181.97 | $213.80 |
Aetna Setting Professional Modifier 78 · Unplanned return to OR Typical Low $1,122.02 Median $1,288.25 Typical High $1,479.11 | Professional | 78 · Unplanned return to OR | $1,122.02 | $1,288.25 | $1,479.11 |
Where Florida sits
The same service costs 5.9 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· 49th of 51
$1,660
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.