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 $776.25 Median $6,025.60 Typical High $12,302.69 | Facility | None | $776.25 | $6,025.60 | $12,302.69 |
Aetna Setting Professional Modifier None Typical Low $316.23 Median $524.81 Typical High $562.34 | Professional | None | $316.23 | $524.81 | $562.34 |
AvMed Setting Facility Modifier None Typical Low $389.05 Median $17,782.79 Typical High $22,908.68 | Facility | None | $389.05 | $17,782.79 | $22,908.68 |
AvMed Setting Professional Modifier None Typical Low $389.05 Median $478.63 Typical High $575.44 | Professional | None | $389.05 | $478.63 | $575.44 |
Cigna Setting Facility Modifier None Typical Low $489.78 Median $17,782.79 Typical High $33,884.42 | Facility | None | $489.78 | $17,782.79 | $33,884.42 |
Cigna Setting Professional Modifier None Typical Low $562.34 Median $562.34 Typical High $2,884.03 | Professional | None | $562.34 | $562.34 | $2,884.03 |
Florida Blue Setting Facility Modifier None Typical Low $2,818.38 Median $5,370.32 Typical High $2,754,228.70 | Facility | None | $2,818.38 | $5,370.32 | $2,754,228.70 |
Florida Blue Setting Professional Modifier None Typical Low $354.81 Median $478.63 Typical High $524.81 | Professional | None | $354.81 | $478.63 | $524.81 |
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 $5,128.61 Median $22,908.68 Typical High $51,286.14 | Facility | None | $5,128.61 | $22,908.68 | $51,286.14 |
United Setting Professional Modifier None Typical Low $426.58 Median $645.65 Typical High $1,318.26 | Professional | None | $426.58 | $645.65 | $1,318.26 |
Wellpoint Setting Professional Modifier None Typical Low $549.54 Median $549.54 Typical High $549.54 | Professional | None | $549.54 | $549.54 | $549.54 |
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 $158.49 Median $263.03 Typical High $281.84 | Professional | 52 · Reduced service | $158.49 | $263.03 | $281.84 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $63.10 Median $104.71 Typical High $112.20 | Professional | 53 · Discontinued | $63.10 | $104.71 | $112.20 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $239.88 Median $398.11 Typical High $426.58 | Professional | 54 · Surgery only | $239.88 | $398.11 | $426.58 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $47.86 Median $79.43 Typical High $85.11 | Professional | 55 · Aftercare only | $47.86 | $79.43 | $85.11 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $31.62 Median $52.48 Typical High $56.23 | Professional | 56 · Pre-op care only | $31.62 | $52.48 | $56.23 |
Where Florida sits
The same service costs 29.5 times more in Louisiana than in Maine. 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· 7th of 51
$4,786
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.