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 $128.82 Median $2,818.38 Typical High $10,964.78 | Facility | None | $128.82 | $2,818.38 | $10,964.78 |
Aetna Setting Professional Modifier None Typical Low $52.48 Median $117.49 Typical High $169.82 | Professional | None | $52.48 | $117.49 | $169.82 |
Ambetter Setting Professional Modifier None Typical Low $134.90 Median $134.90 Typical High $141.25 | Professional | None | $134.90 | $134.90 | $141.25 |
AvMed Setting Facility Modifier None Typical Low $112.20 Median $2,137.96 Typical High $11,748.98 | Facility | None | $112.20 | $2,137.96 | $11,748.98 |
AvMed Setting Professional Modifier None Typical Low $50.12 Median $125.89 Typical High $162.18 | Professional | None | $50.12 | $125.89 | $162.18 |
Cigna Setting Facility Modifier None Typical Low $112.20 Median $229.09 Typical High $1,659.59 | Facility | None | $112.20 | $229.09 | $1,659.59 |
Cigna Setting Professional Modifier None Typical Low $41.69 Median $107.15 Typical High $165.96 | Professional | None | $41.69 | $107.15 | $165.96 |
Florida Blue Setting Facility Modifier None Typical Low $64.57 Median $131.83 Typical High $4,466.84 | Facility | None | $64.57 | $131.83 | $4,466.84 |
Florida Blue Setting Professional Modifier None Typical Low $104.71 Median $117.49 Typical High $165.96 | Professional | None | $104.71 | $117.49 | $165.96 |
Molina Setting Professional Modifier None Typical Low $42.66 Median $128.82 Typical High $190.55 | Professional | None | $42.66 | $128.82 | $190.55 |
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 $42.66 Median $95.50 Typical High $194.98 | Professional | None | $42.66 | $95.50 | $194.98 |
Wellpoint Setting Professional Modifier None Typical Low $38.90 Median $117.49 Typical High $117.49 | Professional | None | $38.90 | $117.49 | $117.49 |
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 $25.12 Median $58.88 Typical High $63.10 | Professional | 52 · Reduced service | $25.12 | $58.88 | $63.10 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $10.23 Median $23.44 Typical High $25.70 | Professional | 53 · Discontinued | $10.23 | $23.44 | $25.70 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $38.02 Median $87.10 Typical High $95.50 | Professional | 54 · Surgery only | $38.02 | $87.10 | $95.50 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $7.59 Median $17.38 Typical High $19.05 | Professional | 55 · Aftercare only | $7.59 | $17.38 | $19.05 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $5.13 Median $11.75 Typical High $12.88 | Professional | 56 · Pre-op care only | $5.13 | $11.75 | $12.88 |
Where Florida sits
The same service costs 2.6 times more in Alaska than in Montana. 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· 46th of 51
$123
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.