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 $1,000.00 Median $7,244.36 Typical High $16,595.87 | Facility | None | $1,000.00 | $7,244.36 | $16,595.87 |
Aetna Setting Professional Modifier None Typical Low $30.90 Median $51.29 Typical High $354.81 | Professional | None | $30.90 | $51.29 | $354.81 |
AvMed Setting Facility Modifier None Typical Low $295.12 Median $2,137.96 Typical High $7,079.46 | Facility | None | $295.12 | $2,137.96 | $7,079.46 |
AvMed Setting Professional Modifier None Typical Low $281.84 Median $346.74 Typical High $398.11 | Professional | None | $281.84 | $346.74 | $398.11 |
Cigna Setting Facility Modifier None Typical Low $501.19 Median $6,760.83 Typical High $12,589.25 | Facility | None | $501.19 | $6,760.83 | $12,589.25 |
Cigna Setting Professional Modifier None Typical Low $302.00 Median $302.00 Typical High $1,819.70 | Professional | None | $302.00 | $302.00 | $1,819.70 |
Florida Blue Setting Facility Modifier None Typical Low $2,691.53 Median $4,265.80 Typical High $8,128.31 | Facility | None | $2,691.53 | $4,265.80 | $8,128.31 |
Florida Blue Setting Professional Modifier None Typical Low $257.04 Median $346.74 Typical High $389.05 | Professional | None | $257.04 | $346.74 | $389.05 |
Molina Setting Professional Modifier None Typical Low $50.12 Median $50.12 Typical High $50.12 | Professional | None | $50.12 | $50.12 | $50.12 |
United Setting Facility Modifier None Typical Low $2,511.89 Median $10,000.00 Typical High $19,498.45 | Facility | None | $2,511.89 | $10,000.00 | $19,498.45 |
United Setting Professional Modifier None Typical Low $43.65 Median $72.44 Typical High $489.78 | Professional | None | $43.65 | $72.44 | $489.78 |
Wellpoint Setting Professional Modifier None Typical Low $389.05 Median $389.05 Typical High $389.05 | Professional | None | $389.05 | $389.05 | $389.05 |
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 $15.49 Median $25.70 Typical High $79.43 | Professional | 52 · Reduced service | $15.49 | $25.70 | $79.43 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $6.17 Median $10.23 Typical High $32.36 | Professional | 53 · Discontinued | $6.17 | $10.23 | $32.36 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $23.44 Median $38.90 Typical High $120.23 | Professional | 54 · Surgery only | $23.44 | $38.90 | $120.23 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $4.68 Median $7.76 Typical High $23.99 | Professional | 55 · Aftercare only | $4.68 | $7.76 | $23.99 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $3.09 Median $5.13 Typical High $15.85 | Professional | 56 · Pre-op care only | $3.09 | $5.13 | $15.85 |
Where Florida sits
The same service costs 93.3 times more in Oregon than in Vermont. 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· 9th of 51
$3,548
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.