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 $218.78 Median $380.19 Typical High $660.69 | Professional | None | $218.78 | $380.19 | $660.69 |
AvMed Setting Facility Modifier None Typical Low $257.04 Median $4,897.79 Typical High $10,964.78 | Facility | None | $257.04 | $4,897.79 | $10,964.78 |
AvMed Setting Professional Modifier None Typical Low $257.04 Median $316.23 Typical High $389.05 | Professional | None | $257.04 | $316.23 | $389.05 |
Cigna Setting Facility Modifier None Typical Low $478.63 Median $4,897.79 Typical High $9,549.93 | Facility | None | $478.63 | $4,897.79 | $9,549.93 |
Cigna Setting Professional Modifier None Typical Low $630.96 Median $630.96 Typical High $3,981.07 | Professional | None | $630.96 | $630.96 | $3,981.07 |
Florida Blue Setting Facility Modifier None Typical Low $1,513.56 Median $2,570.40 Typical High $4,570.88 | Facility | None | $1,513.56 | $2,570.40 | $4,570.88 |
Florida Blue Setting Professional Modifier None Typical Low $234.42 Median $316.23 Typical High $363.08 | Professional | None | $234.42 | $316.23 | $363.08 |
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 $10,715.19 | Facility | None | $954.99 | $2,344.23 | $10,715.19 |
United Setting Professional Modifier None Typical Low $288.40 Median $446.68 Typical High $954.99 | Professional | None | $288.40 | $446.68 | $954.99 |
Wellpoint Setting Professional Modifier None Typical Low $60.26 Median $60.26 Typical High $338.84 | Professional | None | $60.26 | $60.26 | $338.84 |
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 $109.65 Median $181.97 Typical High $295.12 | Professional | 52 · Reduced service | $109.65 | $181.97 | $295.12 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $43.65 Median $72.44 Typical High $117.49 | Professional | 53 · Discontinued | $43.65 | $72.44 | $117.49 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $162.18 Median $275.42 Typical High $446.68 | Professional | 54 · Surgery only | $162.18 | $275.42 | $446.68 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $32.36 Median $54.95 Typical High $89.13 | Professional | 55 · Aftercare only | $32.36 | $54.95 | $89.13 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $21.88 Median $36.31 Typical High $58.88 | Professional | 56 · Pre-op care only | $21.88 | $36.31 | $58.88 |
Where Florida sits
The same service costs 14.8 times more in Texas 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· 11th of 51
$1,950
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.