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 $83.18 Median $3,019.95 Typical High $12,022.64 | Facility | None | $83.18 | $3,019.95 | $12,022.64 |
Aetna Setting Professional Modifier None Typical Low $52.48 Median $83.18 Typical High $138.04 | Professional | None | $52.48 | $83.18 | $138.04 |
Ambetter Setting Professional Modifier None Typical Low $100.00 Median $100.00 Typical High $117.49 | Professional | None | $100.00 | $100.00 | $117.49 |
AvMed Setting Facility Modifier None Typical Low $91.20 Median $2,137.96 Typical High $11,748.98 | Facility | None | $91.20 | $2,137.96 | $11,748.98 |
AvMed Setting Professional Modifier None Typical Low $53.70 Median $104.71 Typical High $141.25 | Professional | None | $53.70 | $104.71 | $141.25 |
Cigna Setting Facility Modifier None Typical Low $52.48 Median $102.33 Typical High $199.53 | Facility | None | $52.48 | $102.33 | $199.53 |
Cigna Setting Professional Modifier None Typical Low $46.77 Median $95.50 Typical High $141.25 | Professional | None | $46.77 | $95.50 | $141.25 |
Florida Blue Setting Facility Modifier None Typical Low $34.67 Median $70.79 Typical High $3,019.95 | Facility | None | $34.67 | $70.79 | $3,019.95 |
Florida Blue Setting Professional Modifier None Typical Low $83.18 Median $95.50 Typical High $144.54 | Professional | None | $83.18 | $95.50 | $144.54 |
Molina Setting Professional Modifier None Typical Low $47.86 Median $109.65 Typical High $177.83 | Professional | None | $47.86 | $109.65 | $177.83 |
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 $44.67 Median $83.18 Typical High $144.54 | Professional | None | $44.67 | $83.18 | $144.54 |
Wellpoint Setting Professional Modifier None Typical Low $43.65 Median $102.33 Typical High $102.33 | Professional | None | $43.65 | $102.33 | $102.33 |
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 $26.30 Median $41.69 Typical High $47.86 | Professional | 52 · Reduced service | $26.30 | $41.69 | $47.86 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $10.47 Median $16.60 Typical High $19.05 | Professional | 53 · Discontinued | $10.47 | $16.60 | $19.05 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $39.81 Median $61.66 Typical High $70.79 | Professional | 54 · Surgery only | $39.81 | $61.66 | $70.79 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $7.94 Median $12.30 Typical High $14.13 | Professional | 55 · Aftercare only | $7.94 | $12.30 | $14.13 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $5.25 Median $8.32 Typical High $9.55 | Professional | 56 · Pre-op care only | $5.25 | $8.32 | $9.55 |
Where Florida sits
The same service costs 3.2 times more in Alaska than in Kentucky. 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· 47th of 51
$95.50
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.