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 $912.01 Median $6,025.60 Typical High $12,302.69 | Facility | None | $912.01 | $6,025.60 | $12,302.69 |
Aetna Setting Professional Modifier None Typical Low $512.86 Median $851.14 Typical High $912.01 | Professional | None | $512.86 | $851.14 | $912.01 |
AvMed Setting Facility Modifier None Typical Low $295.12 Median $2,137.96 Typical High $7,079.46 | Facility | None | $295.12 | $2,137.96 | $7,079.46 |
AvMed Setting Professional Modifier None Typical Low $281.84 Median $346.74 Typical High $398.11 | Professional | None | $281.84 | $346.74 | $398.11 |
Cigna Setting Facility Modifier None Typical Low $478.63 Median $6,760.83 Typical High $12,882.50 | Facility | None | $478.63 | $6,760.83 | $12,882.50 |
Cigna Setting Professional Modifier None Typical Low $302.00 Median $302.00 Typical High $1,778.28 | Professional | None | $302.00 | $302.00 | $1,778.28 |
Florida Blue Setting Facility Modifier None Typical Low $2,691.53 Median $4,265.80 Typical High $8,128.31 | Facility | None | $2,691.53 | $4,265.80 | $8,128.31 |
Florida Blue Setting Professional Modifier None Typical Low $257.04 Median $346.74 Typical High $380.19 | Professional | None | $257.04 | $346.74 | $380.19 |
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 $588.84 Median $977.24 Typical High $2,187.76 | Professional | None | $588.84 | $977.24 | $2,187.76 |
Wellpoint Setting Professional Modifier None Typical Low $371.54 Median $398.11 Typical High $398.11 | Professional | None | $371.54 | $398.11 | $398.11 |
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 $257.04 Median $426.58 Typical High $457.09 | Professional | 52 · Reduced service | $257.04 | $426.58 | $457.09 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $102.33 Median $169.82 Typical High $181.97 | Professional | 53 · Discontinued | $102.33 | $169.82 | $181.97 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $380.19 Median $645.65 Typical High $676.08 | Professional | 54 · Surgery only | $380.19 | $645.65 | $676.08 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $77.62 Median $128.82 Typical High $138.04 | Professional | 55 · Aftercare only | $77.62 | $128.82 | $138.04 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $51.29 Median $85.11 Typical High $91.20 | Professional | 56 · Pre-op care only | $51.29 | $85.11 | $91.20 |
Where Florida sits
The same service costs 16.2 times more in Arkansas than in New York. 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· 9th of 51
$3,467
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.