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 $1,445.44 Median $6,456.54 Typical High $12,302.69 | Facility | None | $1,445.44 | $6,456.54 | $12,302.69 |
Aetna Setting Professional Modifier None Typical Low $5,888.44 Median $10,715.19 Typical High $11,220.18 | Professional | None | $5,888.44 | $10,715.19 | $11,220.18 |
Ambetter Setting Professional Modifier None Typical Low $5,623.41 Median $5,623.41 Typical High $5,623.41 | Professional | None | $5,623.41 | $5,623.41 | $5,623.41 |
AvMed Setting Facility Modifier None Typical Low $8,128.31 Median $8,511.38 Typical High $12,022.64 | Facility | None | $8,128.31 | $8,511.38 | $12,022.64 |
AvMed Setting Professional Modifier None Typical Low $602.56 Median $9,120.11 Typical High $11,481.54 | Professional | None | $602.56 | $9,120.11 | $11,481.54 |
Cigna Setting Facility Modifier None Typical Low $478.63 Median $8,128.31 Typical High $15,488.17 | Facility | None | $478.63 | $8,128.31 | $15,488.17 |
Cigna Setting Professional Modifier None Typical Low $17,782.79 Median $17,782.79 Typical High $17,782.79 | Professional | None | $17,782.79 | $17,782.79 | $17,782.79 |
Florida Blue Setting Facility Modifier None Typical Low $5,128.61 Median $1,148,153.62 Typical High $4,897,788.19 | Facility | None | $5,128.61 | $1,148,153.62 | $4,897,788.19 |
Florida Blue Setting Professional Modifier None Typical Low $7,762.47 Median $10,471.29 Typical High $11,220.18 | Professional | None | $7,762.47 | $10,471.29 | $11,220.18 |
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 $2,511.89 Median $10,000.00 Typical High $19,498.45 | Facility | None | $2,511.89 | $10,000.00 | $19,498.45 |
United Setting Professional Modifier None Typical Low $8,128.31 Median $12,882.50 Typical High $25,118.86 | Professional | None | $8,128.31 | $12,882.50 | $25,118.86 |
Wellpoint Setting Professional Modifier None Typical Low $11,220.18 Median $13,182.57 Typical High $13,182.57 | Professional | None | $11,220.18 | $13,182.57 | $13,182.57 |
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 $3,019.95 Median $5,370.32 Typical High $5,623.41 | Professional | 52 · Reduced service | $3,019.95 | $5,370.32 | $5,623.41 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $1,230.27 Median $2,137.96 Typical High $2,290.87 | Professional | 53 · Discontinued | $1,230.27 | $2,137.96 | $2,290.87 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $4,677.35 Median $7,943.28 Typical High $8,511.38 | Professional | 54 · Surgery only | $4,677.35 | $7,943.28 | $8,511.38 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $912.01 Median $1,584.89 Typical High $1,698.24 | Professional | 55 · Aftercare only | $912.01 | $1,584.89 | $1,698.24 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $616.60 Median $1,071.52 Typical High $1,122.02 | Professional | 56 · Pre-op care only | $616.60 | $1,071.52 | $1,122.02 |
Where Florida sits
The same service costs 16.6 times more in Indiana than in Nebraska. 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· 26th of 51
$10,471
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.