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 $549.54 Median $3,715.35 Typical High $11,481.54 | Facility | None | $549.54 | $3,715.35 | $11,481.54 |
Aetna Setting Professional Modifier None Typical Low $275.42 Median $457.09 Typical High $489.78 | Professional | None | $275.42 | $457.09 | $489.78 |
AvMed Setting Facility Modifier None Typical Low $275.42 Median $2,137.96 Typical High $2,137.96 | Facility | None | $275.42 | $2,137.96 | $2,137.96 |
AvMed Setting Professional Modifier None Typical Low $257.04 Median $323.59 Typical High $371.54 | Professional | None | $257.04 | $323.59 | $371.54 |
Cigna Setting Facility Modifier None Typical Low $501.19 Median $1,318.26 Typical High $5,248.07 | Facility | None | $501.19 | $1,318.26 | $5,248.07 |
Cigna Setting Professional Modifier None Typical Low $309.03 Median $309.03 Typical High $1,698.24 | Professional | None | $309.03 | $309.03 | $1,698.24 |
Florida Blue Setting Facility Modifier None Typical Low $691.83 Median $1,148.15 Typical High $2,238.72 | Facility | None | $691.83 | $1,148.15 | $2,238.72 |
Florida Blue Setting Professional Modifier None Typical Low $239.88 Median $323.59 Typical High $363.08 | Professional | None | $239.88 | $323.59 | $363.08 |
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 $398.11 Median $1,000.00 Typical High $5,623.41 | Facility | None | $398.11 | $1,000.00 | $5,623.41 |
United Setting Professional Modifier None Typical Low $363.08 Median $549.54 Typical High $1,148.15 | Professional | None | $363.08 | $549.54 | $1,148.15 |
Wellpoint Setting Professional Modifier None Typical Low $363.08 Median $436.52 Typical High $436.52 | Professional | None | $363.08 | $436.52 | $436.52 |
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 $138.04 Median $229.09 Typical High $245.47 | Professional | 52 · Reduced service | $138.04 | $229.09 | $245.47 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $54.95 Median $91.20 Typical High $97.72 | Professional | 53 · Discontinued | $54.95 | $91.20 | $97.72 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $204.17 Median $338.84 Typical High $363.08 | Professional | 54 · Surgery only | $204.17 | $338.84 | $363.08 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $40.74 Median $67.61 Typical High $72.44 | Professional | 55 · Aftercare only | $40.74 | $67.61 | $72.44 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $27.54 Median $45.71 Typical High $48.98 | Professional | 56 · Pre-op care only | $27.54 | $45.71 | $48.98 |
Where Florida sits
The same service costs 8.1 times more in Texas than in New York. 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· 17th of 51
$977
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.