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 $12,022.64 | Facility | None | $776.25 | $6,025.60 | $12,022.64 |
Aetna Setting Professional Modifier None Typical Low $147.91 Median $245.47 Typical High $263.03 | Professional | None | $147.91 | $245.47 | $263.03 |
AvMed Setting Facility Modifier None Typical Low $177.83 Median $1,949.84 Typical High $3,890.45 | Facility | None | $177.83 | $1,949.84 | $3,890.45 |
AvMed Setting Professional Modifier None Typical Low $177.83 Median $218.78 Typical High $263.03 | Professional | None | $177.83 | $218.78 | $263.03 |
Cigna Setting Facility Modifier None Typical Low $467.74 Median $2,398.83 Typical High $3,890.45 | Facility | None | $467.74 | $2,398.83 | $3,890.45 |
Cigna Setting Professional Modifier None Typical Low $218.78 Median $218.78 Typical High $1,202.26 | Professional | None | $218.78 | $218.78 | $1,202.26 |
Florida Blue Setting Facility Modifier None Typical Low $1,698.24 Median $3,235.94 Typical High $7,079.46 | Facility | None | $1,698.24 | $3,235.94 | $7,079.46 |
Florida Blue Setting Professional Modifier None Typical Low $162.18 Median $218.78 Typical High $245.47 | Professional | None | $162.18 | $218.78 | $245.47 |
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 $954.99 Median $2,344.23 Typical High $10,000.00 | Facility | None | $954.99 | $2,344.23 | $10,000.00 |
United Setting Professional Modifier None Typical Low $194.98 Median $302.00 Typical High $616.60 | Professional | None | $194.98 | $302.00 | $616.60 |
Wellpoint Setting Professional Modifier None Typical Low $213.80 Median $213.80 Typical High $234.42 | Professional | None | $213.80 | $213.80 | $234.42 |
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 $74.13 Median $123.03 Typical High $131.83 | Professional | 52 · Reduced service | $74.13 | $123.03 | $131.83 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $29.51 Median $48.98 Typical High $52.48 | Professional | 53 · Discontinued | $29.51 | $48.98 | $52.48 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $109.65 Median $186.21 Typical High $194.98 | Professional | 54 · Surgery only | $109.65 | $186.21 | $194.98 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $21.88 Median $37.15 Typical High $38.90 | Professional | 55 · Aftercare only | $21.88 | $37.15 | $38.90 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $14.79 Median $24.55 Typical High $26.30 | Professional | 56 · Pre-op care only | $14.79 | $24.55 | $26.30 |
Where Florida sits
The same service costs 10.7 times more in Colorado 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· 2nd of 51
$2,512
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.