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 $407.38 Median $3,311.31 Typical High $11,481.54 | Facility | None | $407.38 | $3,311.31 | $11,481.54 |
Aetna Setting Professional Modifier None Typical Low $194.98 Median $316.23 Typical High $316.23 | Professional | None | $194.98 | $316.23 | $316.23 |
AvMed Setting Facility Modifier None Typical Low $218.78 Median $2,041.74 Typical High $2,137.96 | Facility | None | $218.78 | $2,041.74 | $2,137.96 |
AvMed Setting Professional Modifier None Typical Low $117.49 Median $229.09 Typical High $288.40 | Professional | None | $117.49 | $229.09 | $288.40 |
Cigna Setting Facility Modifier None Typical Low $489.78 Median $1,698.24 Typical High $2,884.03 | Facility | None | $489.78 | $1,698.24 | $2,884.03 |
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 $1,513.56 Median $2,630.27 Typical High $5,011.87 | Facility | None | $1,513.56 | $2,630.27 | $5,011.87 |
Florida Blue Setting Professional Modifier None Typical Low $138.04 Median $263.03 Typical High $275.42 | Professional | None | $138.04 | $263.03 | $275.42 |
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 $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 $186.21 Median $275.42 Typical High $512.86 | Professional | None | $186.21 | $275.42 | $512.86 |
Wellpoint Setting Professional Modifier None Typical Low $147.91 Median $147.91 Typical High $263.03 | Professional | None | $147.91 | $147.91 | $263.03 |
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 $97.72 Median $158.49 Typical High $158.49 | Professional | 52 · Reduced service | $97.72 | $158.49 | $158.49 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $38.90 Median $63.10 Typical High $63.10 | Professional | 53 · Discontinued | $38.90 | $63.10 | $63.10 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $144.54 Median $234.42 Typical High $234.42 | Professional | 54 · Surgery only | $144.54 | $234.42 | $234.42 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $29.51 Median $47.86 Typical High $47.86 | Professional | 55 · Aftercare only | $29.51 | $47.86 | $47.86 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $19.50 Median $31.62 Typical High $31.62 | Professional | 56 · Pre-op care only | $19.50 | $31.62 | $31.62 |
Where Florida sits
The same service costs 19.5 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· 2nd of 51
$1,660
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.