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 $208.93 Median $346.74 Typical High $371.54 | Professional | None | $208.93 | $346.74 | $371.54 |
AvMed Setting Facility Modifier None Typical Low $257.04 Median $7,079.46 Typical High $10,964.78 | Facility | None | $257.04 | $7,079.46 | $10,964.78 |
AvMed Setting Professional Modifier None Typical Low $257.04 Median $323.59 Typical High $371.54 | Professional | None | $257.04 | $323.59 | $371.54 |
Cigna Setting Facility Modifier None Typical Low $478.63 Median $7,079.46 Typical High $13,489.63 | Facility | None | $478.63 | $7,079.46 | $13,489.63 |
Cigna Setting Professional Modifier None Typical Low $323.59 Median $323.59 Typical High $1,778.28 | Professional | None | $323.59 | $323.59 | $1,778.28 |
Florida Blue Setting Facility Modifier None Typical Low $2,691.53 Median $4,466.84 Typical High $8,128.31 | Facility | None | $2,691.53 | $4,466.84 | $8,128.31 |
Florida Blue Setting Professional Modifier None Typical Low $234.42 Median $323.59 Typical High $346.74 | Professional | None | $234.42 | $323.59 | $346.74 |
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 $275.42 Median $426.58 Typical High $870.96 | Professional | None | $275.42 | $426.58 | $870.96 |
Wellpoint Setting Professional Modifier None Typical Low $354.81 Median $436.52 Typical High $436.52 | Professional | None | $354.81 | $436.52 | $436.52 |
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 $102.33 Median $173.78 Typical High $181.97 | Professional | 52 · Reduced service | $102.33 | $173.78 | $181.97 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $41.69 Median $69.18 Typical High $74.13 | Professional | 53 · Discontinued | $41.69 | $69.18 | $74.13 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $154.88 Median $257.04 Typical High $275.42 | Professional | 54 · Surgery only | $154.88 | $257.04 | $275.42 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $30.90 Median $51.29 Typical High $54.95 | Professional | 55 · Aftercare only | $30.90 | $51.29 | $54.95 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $20.89 Median $34.67 Typical High $37.15 | Professional | 56 · Pre-op care only | $20.89 | $34.67 | $37.15 |
Where Florida sits
The same service costs 15.8 times more in Arkansas 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· 6th of 51
$3,631
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.