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 $100.00 Median $177.83 Typical High $229.09 | Professional | None | $100.00 | $177.83 | $229.09 |
Ambetter Setting Professional Modifier None Typical Low $83.18 Median $316.23 Typical High $831.76 | Professional | None | $83.18 | $316.23 | $831.76 |
AvMed Setting Facility Modifier None Typical Low $112.20 Median $1,445.44 Typical High $2,137.96 | Facility | None | $112.20 | $1,445.44 | $2,137.96 |
AvMed Setting Professional Modifier None Typical Low $42.66 Median $112.20 Typical High $144.54 | Professional | None | $42.66 | $112.20 | $144.54 |
Cigna Setting Facility Modifier None Typical Low $380.19 Median $512.86 Typical High $1,659.59 | Facility | None | $380.19 | $512.86 | $1,659.59 |
Cigna Setting Professional Modifier None Typical Low $1,548.82 Median $1,548.82 Typical High $1,548.82 | Professional | None | $1,548.82 | $1,548.82 | $1,548.82 |
Florida Blue Setting Facility Modifier None Typical Low $257.04 Median $436.52 Typical High $851.14 | Facility | None | $257.04 | $436.52 | $851.14 |
Florida Blue Setting Professional Modifier None Typical Low $97.72 Median $134.90 Typical High $162.18 | Professional | None | $97.72 | $134.90 | $162.18 |
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 $281.84 Median $660.69 Typical High $4,073.80 | Facility | None | $281.84 | $660.69 | $4,073.80 |
United Setting Professional Modifier None Typical Low $107.15 Median $151.36 Typical High $323.59 | Professional | None | $107.15 | $151.36 | $323.59 |
Wellpoint Setting Professional Modifier None Typical Low $141.25 Median $501.19 Typical High $501.19 | Professional | None | $141.25 | $501.19 | $501.19 |
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 $50.12 Median $89.13 Typical High $95.50 | Professional | 52 · Reduced service | $50.12 | $89.13 | $95.50 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $19.95 Median $35.48 Typical High $38.02 | Professional | 53 · Discontinued | $19.95 | $35.48 | $38.02 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $75.86 Median $134.90 Typical High $138.04 | Professional | 54 · Surgery only | $75.86 | $134.90 | $138.04 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $15.14 Median $26.92 Typical High $28.84 | Professional | 55 · Aftercare only | $15.14 | $26.92 | $28.84 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $10.00 Median $17.78 Typical High $19.05 | Professional | 56 · Pre-op care only | $10.00 | $17.78 | $19.05 |
Where Florida sits
The same service costs 8.3 times more in Oklahoma than in Rhode Island. 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· 33rd of 51
$372
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.