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 $407.38 Median $3,090.30 Typical High $11,481.54 | Facility | None | $407.38 | $3,090.30 | $11,481.54 |
Aetna Setting Professional Modifier None Typical Low $85.11 Median $141.25 Typical High $158.49 | Professional | None | $85.11 | $141.25 | $158.49 |
AvMed Setting Facility Modifier None Typical Low $120.23 Median $1,548.82 Typical High $1,949.84 | Facility | None | $120.23 | $1,548.82 | $1,949.84 |
AvMed Setting Professional Modifier None Typical Low $114.82 Median $1,548.82 Typical High $2,089.30 | Professional | None | $114.82 | $1,548.82 | $2,089.30 |
Cigna Setting Facility Modifier None Typical Low $302.00 Median $457.09 Typical High $2,187.76 | Facility | None | $302.00 | $457.09 | $2,187.76 |
Cigna Setting Professional Modifier None Typical Low $9,772.37 Median $9,772.37 Typical High $9,772.37 | Professional | None | $9,772.37 | $9,772.37 | $9,772.37 |
Florida Blue Setting Facility Modifier None Typical Low $446.68 Median $758.58 Typical High $1,479.11 | Facility | None | $446.68 | $758.58 | $1,479.11 |
Florida Blue Setting Professional Modifier None Typical Low $83.18 Median $1,348.96 Typical High $1,548.82 | Professional | None | $83.18 | $1,348.96 | $1,548.82 |
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 $281.84 Median $660.69 Typical High $4,073.80 | Facility | None | $281.84 | $660.69 | $4,073.80 |
United Setting Professional Modifier None Typical Low $114.82 Median $169.82 Typical High $549.54 | Professional | None | $114.82 | $169.82 | $549.54 |
Wellpoint Setting Professional Modifier None Typical Low $112.20 Median $1,949.84 Typical High $2,041.74 | Professional | None | $112.20 | $1,949.84 | $2,041.74 |
4 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 $42.66 Median $70.79 Typical High $75.86 | Professional | 52 · Reduced service | $42.66 | $70.79 | $75.86 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $16.98 Median $28.18 Typical High $30.20 | Professional | 53 · Discontinued | $16.98 | $28.18 | $30.20 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $12.59 Median $21.38 Typical High $22.39 | Professional | 55 · Aftercare only | $12.59 | $21.38 | $22.39 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $8.51 Median $14.13 Typical High $15.14 | Professional | 56 · Pre-op care only | $8.51 | $14.13 | $15.14 |
Where Florida sits
The same service costs 24.5 times more in Texas than in Missouri. 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· 3rd of 51
$537
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.