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 $151.36 Median $3,311.31 Typical High $12,022.64 | Facility | None | $151.36 | $3,311.31 | $12,022.64 |
Aetna Setting Professional Modifier None Typical Low $81.28 Median $120.23 Typical High $190.55 | Professional | None | $81.28 | $120.23 | $190.55 |
Ambetter Setting Professional Modifier None Typical Low $165.96 Median $165.96 Typical High $165.96 | Professional | None | $165.96 | $165.96 | $165.96 |
AvMed Setting Facility Modifier None Typical Low $114.82 Median $2,137.96 Typical High $11,748.98 | Facility | None | $114.82 | $2,137.96 | $11,748.98 |
AvMed Setting Professional Modifier None Typical Low $81.28 Median $144.54 Typical High $190.55 | Professional | None | $81.28 | $144.54 | $190.55 |
Cigna Setting Facility Modifier None Typical Low $54.95 Median $131.83 Typical High $309.03 | Facility | None | $54.95 | $131.83 | $309.03 |
Cigna Setting Professional Modifier None Typical Low $70.79 Median $125.89 Typical High $199.53 | Professional | None | $70.79 | $125.89 | $199.53 |
Florida Blue Setting Facility Modifier None Typical Low $64.57 Median $131.83 Typical High $3,981.07 | Facility | None | $64.57 | $131.83 | $3,981.07 |
Florida Blue Setting Professional Modifier None Typical Low $123.03 Median $131.83 Typical High $194.98 | Professional | None | $123.03 | $131.83 | $194.98 |
Molina Setting Professional Modifier None Typical Low $72.44 Median $144.54 Typical High $223.87 | Professional | None | $72.44 | $144.54 | $223.87 |
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 $64.57 Median $117.49 Typical High $208.93 | Professional | None | $64.57 | $117.49 | $208.93 |
Wellpoint Setting Professional Modifier None Typical Low $66.07 Median $138.04 Typical High $138.04 | Professional | None | $66.07 | $138.04 | $138.04 |
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 $40.74 Median $60.26 Typical High $79.43 | Professional | 52 · Reduced service | $40.74 | $60.26 | $79.43 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $16.22 Median $23.99 Typical High $31.62 | Professional | 53 · Discontinued | $16.22 | $23.99 | $31.62 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $60.26 Median $89.13 Typical High $120.23 | Professional | 54 · Surgery only | $60.26 | $89.13 | $120.23 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $12.02 Median $17.78 Typical High $23.99 | Professional | 55 · Aftercare only | $12.02 | $17.78 | $23.99 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $8.13 Median $12.02 Typical High $15.85 | Professional | 56 · Pre-op care only | $8.13 | $12.02 | $15.85 |
Where Florida sits
The same service costs 3.3 times more in Alaska than in Maryland. 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· 48th of 51
$132
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.