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 $177.83 Median $239.88 Typical High $251.19 | Professional | None | $177.83 | $239.88 | $251.19 |
AvMed Setting Facility Modifier None Typical Low $204.17 Median $2,137.96 Typical High $12,882.50 | Facility | None | $204.17 | $2,137.96 | $12,882.50 |
AvMed Setting Professional Modifier None Typical Low $70.79 Median $204.17 Typical High $281.84 | Professional | None | $70.79 | $204.17 | $281.84 |
Cigna Setting Facility Modifier None Typical Low $446.68 Median $1,047.13 Typical High $2,691.53 | Facility | None | $446.68 | $1,047.13 | $2,691.53 |
Cigna Setting Professional Modifier None Typical Low $134.90 Median $169.82 Typical High $446.68 | Professional | None | $134.90 | $169.82 | $446.68 |
Florida Blue Setting Facility Modifier None Typical Low $208.93 Median $380.19 Typical High $2,089.30 | Facility | None | $208.93 | $380.19 | $2,089.30 |
Florida Blue Setting Professional Modifier None Typical Low $154.88 Median $229.09 Typical High $281.84 | Professional | None | $154.88 | $229.09 | $281.84 |
Molina Setting Professional Modifier None Typical Low $54.95 Median $95.50 Typical High $165.96 | Professional | None | $54.95 | $95.50 | $165.96 |
United Setting Facility Modifier None Typical Low $81.28 Median $302.00 Typical High $2,818.38 | Facility | None | $81.28 | $302.00 | $2,818.38 |
United Setting Professional Modifier None Typical Low $190.55 Median $295.12 Typical High $549.54 | Professional | None | $190.55 | $295.12 | $549.54 |
Wellpoint Setting Professional Modifier None Typical Low $48.98 Median $100.00 Typical High $100.00 | Professional | None | $48.98 | $100.00 | $100.00 |
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 $87.10 Median $120.23 Typical High $120.23 | Professional | 52 · Reduced service | $87.10 | $120.23 | $120.23 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $35.48 Median $47.86 Typical High $47.86 | Professional | 53 · Discontinued | $35.48 | $47.86 | $47.86 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $131.83 Median $177.83 Typical High $181.97 | Professional | 54 · Surgery only | $131.83 | $177.83 | $181.97 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $26.30 Median $35.48 Typical High $36.31 | Professional | 55 · Aftercare only | $26.30 | $35.48 | $36.31 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $17.78 Median $23.99 Typical High $23.99 | Professional | 56 · Pre-op care only | $17.78 | $23.99 | $23.99 |
Where Florida sits
The same service costs 7.2 times more in Oklahoma than in Virginia. 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· 35th of 51
$251
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.