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 $851.14 Median $6,025.60 Typical High $12,882.50 | Facility | None | $851.14 | $6,025.60 | $12,882.50 |
Aetna Setting Professional Modifier None Typical Low $1,548.82 Median $1,698.24 Typical High $1,995.26 | Professional | None | $1,548.82 | $1,698.24 | $1,995.26 |
AvMed Setting Facility Modifier None Typical Low $1,318.26 Median $2,818.38 Typical High $11,748.98 | Facility | None | $1,318.26 | $2,818.38 | $11,748.98 |
AvMed Setting Professional Modifier None Typical Low $1,380.38 Median $1,819.70 Typical High $2,137.96 | Professional | None | $1,380.38 | $1,819.70 | $2,137.96 |
Cigna Setting Facility Modifier None Typical Low $501.19 Median $2,951.21 Typical High $5,370.32 | Facility | None | $501.19 | $2,951.21 | $5,370.32 |
Cigna Setting Professional Modifier None Typical Low $1,348.96 Median $1,862.09 Typical High $3,467.37 | Professional | None | $1,348.96 | $1,862.09 | $3,467.37 |
Florida Blue Setting Facility Modifier None Typical Low $1,737.80 Median $3,548.13 Typical High $16,982.44 | Facility | None | $1,737.80 | $3,548.13 | $16,982.44 |
Florida Blue Setting Professional Modifier None Typical Low $1,174.90 Median $1,258.93 Typical High $1,862.09 | Professional | None | $1,174.90 | $1,258.93 | $1,862.09 |
Molina Setting Professional Modifier None Typical Low $109.65 Median $1,202.26 Typical High $2,818.38 | Professional | None | $109.65 | $1,202.26 | $2,818.38 |
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 $60.26 Median $2,041.74 Typical High $3,890.45 | Professional | None | $60.26 | $2,041.74 | $3,890.45 |
Wellpoint Setting Professional Modifier None Typical Low $1,288.25 Median $1,288.25 Typical High $1,659.59 | Professional | None | $1,288.25 | $1,288.25 | $1,659.59 |
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 $776.25 Median $851.14 Typical High $1,000.00 | Professional | 52 · Reduced service | $776.25 | $851.14 | $1,000.00 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $309.03 Median $338.84 Typical High $398.11 | Professional | 53 · Discontinued | $309.03 | $338.84 | $398.11 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $1,148.15 Median $1,258.93 Typical High $1,513.56 | Professional | 54 · Surgery only | $1,148.15 | $1,258.93 | $1,513.56 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $229.09 Median $251.19 Typical High $302.00 | Professional | 55 · Aftercare only | $229.09 | $251.19 | $302.00 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $154.88 Median $169.82 Typical High $199.53 | Professional | 56 · Pre-op care only | $154.88 | $169.82 | $199.53 |
Aetna Setting Professional Modifier 78 · Unplanned return to OR Typical Low $1,071.52 Median $1,174.90 Typical High $1,412.54 | Professional | 78 · Unplanned return to OR | $1,071.52 | $1,174.90 | $1,412.54 |
Where Florida sits
The same service costs 6.9 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· 46th of 51
$1,738
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.