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 $3,311.31 Typical High $12,022.64 | Facility | None | $128.82 | $3,311.31 | $12,022.64 |
Aetna Setting Professional Modifier None Typical Low $60.26 Median $95.50 Typical High $162.18 | Professional | None | $60.26 | $95.50 | $162.18 |
Ambetter Setting Professional Modifier None Typical Low $114.82 Median $134.90 Typical High $141.25 | Professional | None | $114.82 | $134.90 | $141.25 |
AvMed Setting Facility Modifier None Typical Low $102.33 Median $2,137.96 Typical High $11,748.98 | Facility | None | $102.33 | $2,137.96 | $11,748.98 |
AvMed Setting Professional Modifier None Typical Low $64.57 Median $117.49 Typical High $162.18 | Professional | None | $64.57 | $117.49 | $162.18 |
Cigna Setting Facility Modifier None Typical Low $52.48 Median $114.82 Typical High $223.87 | Facility | None | $52.48 | $114.82 | $223.87 |
Cigna Setting Professional Modifier None Typical Low $56.23 Median $109.65 Typical High $165.96 | Professional | None | $56.23 | $109.65 | $165.96 |
Florida Blue Setting Facility Modifier None Typical Low $63.10 Median $131.83 Typical High $3,981.07 | Facility | None | $63.10 | $131.83 | $3,981.07 |
Florida Blue Setting Professional Modifier None Typical Low $95.50 Median $109.65 Typical High $165.96 | Professional | None | $95.50 | $109.65 | $165.96 |
Molina Setting Professional Modifier None Typical Low $56.23 Median $117.49 Typical High $181.97 | Professional | None | $56.23 | $117.49 | $181.97 |
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 $53.70 Median $97.72 Typical High $173.78 | Professional | None | $53.70 | $97.72 | $173.78 |
Wellpoint Setting Professional Modifier None Typical Low $51.29 Median $117.49 Typical High $117.49 | Professional | None | $51.29 | $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 $30.20 Median $47.86 Typical High $69.18 | Professional | 52 · Reduced service | $30.20 | $47.86 | $69.18 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $12.30 Median $19.05 Typical High $27.54 | Professional | 53 · Discontinued | $12.30 | $19.05 | $27.54 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $45.71 Median $72.44 Typical High $102.33 | Professional | 54 · Surgery only | $45.71 | $72.44 | $102.33 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $9.12 Median $14.45 Typical High $20.42 | Professional | 55 · Aftercare only | $9.12 | $14.45 | $20.42 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $6.03 Median $9.55 Typical High $13.80 | Professional | 56 · Pre-op care only | $6.03 | $9.55 | $13.80 |
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· 45th of 51
$115
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.