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 $724.44 Median $5,495.41 Typical High $12,022.64 | Facility | None | $724.44 | $5,495.41 | $12,022.64 |
Aetna Setting Professional Modifier None Typical Low $436.52 Median $724.44 Typical High $776.25 | Professional | None | $436.52 | $724.44 | $776.25 |
AvMed Setting Facility Modifier None Typical Low $562.34 Median $2,137.96 Typical High $4,570.88 | Facility | None | $562.34 | $2,137.96 | $4,570.88 |
Cigna Setting Facility Modifier None Typical Low $489.78 Median $2,691.53 Typical High $4,265.80 | Facility | None | $489.78 | $2,691.53 | $4,265.80 |
Cigna Setting Professional Modifier None Typical Low $223.87 Median $223.87 Typical High $1,230.27 | Professional | None | $223.87 | $223.87 | $1,230.27 |
Florida Blue Setting Facility Modifier None Typical Low $1,659.59 Median $2,754.23 Typical High $5,011.87 | Facility | None | $1,659.59 | $2,754.23 | $5,011.87 |
Florida Blue Setting Professional Modifier None Typical Low $181.97 Median $190.55 Typical High $302.00 | Professional | None | $181.97 | $190.55 | $302.00 |
Molina Setting Professional Modifier None Typical Low $39.81 Median $39.81 Typical High $50.12 | Professional | None | $39.81 | $39.81 | $50.12 |
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 $467.74 Median $776.25 Typical High $1,479.11 | Professional | None | $467.74 | $776.25 | $1,479.11 |
Wellpoint Setting Professional Modifier None Typical Low $1,995.26 Median $1,995.26 Typical High $1,995.26 | Professional | None | $1,995.26 | $1,995.26 | $1,995.26 |
5 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 $213.80 Median $363.08 Typical High $380.19 | Professional | 52 · Reduced service | $213.80 | $363.08 | $380.19 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $87.10 Median $144.54 Typical High $154.88 | Professional | 53 · Discontinued | $87.10 | $144.54 | $154.88 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $323.59 Median $537.03 Typical High $575.44 | Professional | 54 · Surgery only | $323.59 | $537.03 | $575.44 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $64.57 Median $107.15 Typical High $114.82 | Professional | 55 · Aftercare only | $64.57 | $107.15 | $114.82 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $43.65 Median $72.44 Typical High $77.62 | Professional | 56 · Pre-op care only | $43.65 | $72.44 | $77.62 |
Where Florida sits
The same service costs 12.6 times more in Ohio than in Nebraska. 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· 8th of 51
$2,089
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.