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 $3,090.30 Typical High $11,481.54 | Facility | None | $407.38 | $3,090.30 | $11,481.54 |
Aetna Setting Professional Modifier None Typical Low $87.10 Median $398.11 Typical High $398.11 | Professional | None | $87.10 | $398.11 | $398.11 |
AvMed Setting Facility Modifier None Typical Low $53.70 Median $512.86 Typical High $2,137.96 | Facility | None | $53.70 | $512.86 | $2,137.96 |
AvMed Setting Professional Modifier None Typical Low $57.54 Median $83.18 Typical High $107.15 | Professional | None | $57.54 | $83.18 | $107.15 |
Cigna Setting Facility Modifier None Typical Low $52.48 Median $66.07 Typical High $562.34 | Facility | None | $52.48 | $66.07 | $562.34 |
Cigna Setting Professional Modifier None Typical Low $489.78 Median $489.78 Typical High $489.78 | Professional | None | $489.78 | $489.78 | $489.78 |
Florida Blue Setting Facility Modifier None Typical Low $60.26 Median $93.33 Typical High $181.97 | Facility | None | $60.26 | $93.33 | $181.97 |
Florida Blue Setting Professional Modifier None Typical Low $69.18 Median $77.62 Typical High $114.82 | Professional | None | $69.18 | $77.62 | $114.82 |
Molina Setting Professional Modifier None Typical Low $89.13 Median $114.82 Typical High $147.91 | Professional | None | $89.13 | $114.82 | $147.91 |
United Setting Facility Modifier None Typical Low $81.28 Median $302.00 Typical High $2,818.38 | Facility | None | $81.28 | $302.00 | $2,818.38 |
United Setting Professional Modifier None Typical Low $50.12 Median $77.62 Typical High $141.25 | Professional | None | $50.12 | $77.62 | $141.25 |
Wellpoint Setting Professional Modifier None Typical Low $56.23 Median $100.00 Typical High $100.00 | Professional | None | $56.23 | $100.00 | $100.00 |
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 $44.67 Median $199.53 Typical High $199.53 | Professional | 52 · Reduced service | $44.67 | $199.53 | $199.53 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $17.78 Median $79.43 Typical High $79.43 | Professional | 53 · Discontinued | $17.78 | $79.43 | $79.43 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $69.18 Median $302.00 Typical High $302.00 | Professional | 54 · Surgery only | $69.18 | $302.00 | $302.00 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $13.49 Median $60.26 Typical High $60.26 | Professional | 55 · Aftercare only | $13.49 | $60.26 | $60.26 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $8.91 Median $39.81 Typical High $39.81 | Professional | 56 · Pre-op care only | $8.91 | $39.81 | $39.81 |
Where Florida sits
The same service costs 3.4 times more in Alaska than in Virginia. 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· 37th of 51
$102
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.