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 $4,786.30 Typical High $11,748.98 | Facility | None | $776.25 | $4,786.30 | $11,748.98 |
Aetna Setting Professional Modifier None Typical Low $1,258.93 Median $1,288.25 Typical High $1,621.81 | Professional | None | $1,258.93 | $1,288.25 | $1,621.81 |
AvMed Setting Facility Modifier None Typical Low $912.01 Median $2,137.96 Typical High $9,772.37 | Facility | None | $912.01 | $2,137.96 | $9,772.37 |
AvMed Setting Professional Modifier None Typical Low $1,071.52 Median $1,412.54 Typical High $1,778.28 | Professional | None | $1,071.52 | $1,412.54 | $1,778.28 |
Cigna Setting Facility Modifier None Typical Low $501.19 Median $3,890.45 Typical High $7,413.10 | Facility | None | $501.19 | $3,890.45 | $7,413.10 |
Cigna Setting Professional Modifier None Typical Low $1,023.29 Median $1,096.48 Typical High $2,290.87 | Professional | None | $1,023.29 | $1,096.48 | $2,290.87 |
Florida Blue Setting Facility Modifier None Typical Low $1,318.26 Median $2,630.27 Typical High $16,982.44 | Facility | None | $1,318.26 | $2,630.27 | $16,982.44 |
Florida Blue Setting Professional Modifier None Typical Low $691.83 Median $1,288.25 Typical High $1,621.81 | Professional | None | $691.83 | $1,288.25 | $1,621.81 |
Molina Setting Professional Modifier None Typical Low $147.91 Median $912.01 Typical High $1,621.81 | Professional | None | $147.91 | $912.01 | $1,621.81 |
United Setting Facility Modifier None Typical Low $1,230.27 Median $3,311.31 Typical High $12,589.25 | Facility | None | $1,230.27 | $3,311.31 | $12,589.25 |
United Setting Professional Modifier None Typical Low $977.24 Median $1,258.93 Typical High $2,454.71 | Professional | None | $977.24 | $1,258.93 | $2,454.71 |
Wellpoint Setting Professional Modifier None Typical Low $1,000.00 Median $1,000.00 Typical High $1,348.96 | Professional | None | $1,000.00 | $1,000.00 | $1,348.96 |
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 $645.65 Median $645.65 Typical High $812.83 | Professional | 52 · Reduced service | $645.65 | $645.65 | $812.83 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $257.04 Median $257.04 Typical High $323.59 | Professional | 53 · Discontinued | $257.04 | $257.04 | $323.59 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $954.99 Median $977.24 Typical High $1,230.27 | Professional | 54 · Surgery only | $954.99 | $977.24 | $1,230.27 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $190.55 Median $194.98 Typical High $245.47 | Professional | 55 · Aftercare only | $190.55 | $194.98 | $245.47 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $128.82 Median $128.82 Typical High $162.18 | Professional | 56 · Pre-op care only | $128.82 | $128.82 | $162.18 |
Aetna Setting Professional Modifier 78 · Unplanned return to OR Typical Low $891.25 Median $912.01 Typical High $1,148.15 | Professional | 78 · Unplanned return to OR | $891.25 | $912.01 | $1,148.15 |
Where Florida sits
The same service costs 24.5 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
$1,230
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.