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 $707.95 Median $4,786.30 Typical High $11,748.98 | Facility | None | $707.95 | $4,786.30 | $11,748.98 |
Aetna Setting Professional Modifier None Typical Low $446.68 Median $758.58 Typical High $812.83 | Professional | None | $446.68 | $758.58 | $812.83 |
AvMed Setting Facility Modifier None Typical Low $524.81 Median $2,137.96 Typical High $5,495.41 | Facility | None | $524.81 | $2,137.96 | $5,495.41 |
AvMed Setting Professional Modifier None Typical Low $501.19 Median $660.69 Typical High $707.95 | Professional | None | $501.19 | $660.69 | $707.95 |
Cigna Setting Facility Modifier None Typical Low $501.19 Median $3,801.89 Typical High $7,079.46 | Facility | None | $501.19 | $3,801.89 | $7,079.46 |
Cigna Setting Professional Modifier None Typical Low $1,258.93 Median $3,801.89 Typical High $3,801.89 | Professional | None | $1,258.93 | $3,801.89 | $3,801.89 |
Florida Blue Setting Facility Modifier None Typical Low $2,454.71 Median $4,168.69 Typical High $8,128.31 | Facility | None | $2,454.71 | $4,168.69 | $8,128.31 |
Florida Blue Setting Professional Modifier None Typical Low $338.84 Median $660.69 Typical High $776.25 | Professional | None | $338.84 | $660.69 | $776.25 |
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 $549.54 Median $691.83 Typical High $1,202.26 | Professional | None | $549.54 | $691.83 | $1,202.26 |
Wellpoint Setting Professional Modifier None Typical Low $776.25 Median $3,548.13 Typical High $3,548.13 | Professional | None | $776.25 | $3,548.13 | $3,548.13 |
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 $223.87 Median $380.19 Typical High $398.11 | Professional | 52 · Reduced service | $223.87 | $380.19 | $398.11 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $91.20 Median $151.36 Typical High $162.18 | Professional | 53 · Discontinued | $91.20 | $151.36 | $162.18 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $338.84 Median $562.34 Typical High $602.56 | Professional | 54 · Surgery only | $338.84 | $562.34 | $602.56 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $67.61 Median $112.20 Typical High $120.23 | Professional | 55 · Aftercare only | $67.61 | $112.20 | $120.23 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $44.67 Median $75.86 Typical High $81.28 | Professional | 56 · Pre-op care only | $44.67 | $75.86 | $81.28 |
Where Florida sits
The same service costs 5.1 times more in Texas than in Delaware. 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· 5th of 51
$2,239
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.