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 $169.82 Median $281.84 Typical High $302.00 | Professional | None | $169.82 | $281.84 | $302.00 |
AvMed Setting Facility Modifier None Typical Low $467.74 Median $2,137.96 Typical High $2,691.53 | Facility | None | $467.74 | $2,137.96 | $2,691.53 |
Cigna Setting Facility Modifier None Typical Low $416.87 Median $812.83 Typical High $1,659.59 | Facility | None | $416.87 | $812.83 | $1,659.59 |
Cigna Setting Professional Modifier None Typical Low $245.47 Median $245.47 Typical High $1,348.96 | Professional | None | $245.47 | $245.47 | $1,348.96 |
Florida Blue Setting Facility Modifier None Typical Low $478.63 Median $575.44 Typical High $575.44 | Facility | None | $478.63 | $575.44 | $575.44 |
Florida Blue Setting Professional Modifier None Typical Low $204.17 Median $213.80 Typical High $309.03 | Professional | None | $204.17 | $213.80 | $309.03 |
Molina Setting Professional Modifier None Typical Low $39.81 Median $39.81 Typical High $50.12 | Professional | None | $39.81 | $39.81 | $50.12 |
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 $229.09 Median $331.13 Typical High $616.60 | Professional | None | $229.09 | $331.13 | $616.60 |
Wellpoint Setting Professional Modifier None Typical Low $190.55 Median $190.55 Typical High $190.55 | Professional | None | $190.55 | $190.55 | $190.55 |
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 $83.18 Median $141.25 Typical High $147.91 | Professional | 52 · Reduced service | $83.18 | $141.25 | $147.91 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $33.88 Median $56.23 Typical High $60.26 | Professional | 53 · Discontinued | $33.88 | $56.23 | $60.26 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $125.89 Median $208.93 Typical High $223.87 | Professional | 54 · Surgery only | $125.89 | $208.93 | $223.87 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $25.12 Median $41.69 Typical High $44.67 | Professional | 55 · Aftercare only | $25.12 | $41.69 | $44.67 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $16.98 Median $28.18 Typical High $30.20 | Professional | 56 · Pre-op care only | $16.98 | $28.18 | $30.20 |
Where Florida sits
The same service costs 8.3 times more in Alaska 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· 35th of 51
$302
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.