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 $588.84 Median $3,890.45 Typical High $12,022.64 | Facility | None | $588.84 | $3,890.45 | $12,022.64 |
Aetna Setting Professional Modifier None Typical Low $61.66 Median $66.07 Typical High $75.86 | Professional | None | $61.66 | $66.07 | $75.86 |
AvMed Setting Facility Modifier None Typical Low $501.19 Median $2,137.96 Typical High $12,882.50 | Facility | None | $501.19 | $2,137.96 | $12,882.50 |
Cigna Setting Facility Modifier None Typical Low $52.48 Median $436.52 Typical High $794.33 | Facility | None | $52.48 | $436.52 | $794.33 |
Cigna Setting Professional Modifier None Typical Low $56.23 Median $64.57 Typical High $109.65 | Professional | None | $56.23 | $64.57 | $109.65 |
Florida Blue Setting Facility Modifier None Typical Low $64.57 Median $141.25 Typical High $4,466.84 | Facility | None | $64.57 | $141.25 | $4,466.84 |
Florida Blue Setting Professional Modifier None Typical Low $20.42 Median $22.39 Typical High $34.67 | Professional | None | $20.42 | $22.39 | $34.67 |
Molina Setting Professional Modifier None Typical Low $39.81 Median $39.81 Typical High $50.12 | Professional | None | $39.81 | $39.81 | $50.12 |
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 $46.77 Median $66.07 Typical High $120.23 | Professional | None | $46.77 | $66.07 | $120.23 |
Wellpoint Setting Professional Modifier None Typical Low $72.44 Median $72.44 Typical High $72.44 | Professional | None | $72.44 | $72.44 | $72.44 |
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 $30.90 Median $33.11 Typical High $34.67 | Professional | 52 · Reduced service | $30.90 | $33.11 | $34.67 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $12.30 Median $13.49 Typical High $14.13 | Professional | 53 · Discontinued | $12.30 | $13.49 | $14.13 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $46.77 Median $50.12 Typical High $52.48 | Professional | 54 · Surgery only | $46.77 | $50.12 | $52.48 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $9.33 Median $10.00 Typical High $10.47 | Professional | 55 · Aftercare only | $9.33 | $10.00 | $10.47 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $6.17 Median $6.61 Typical High $7.08 | Professional | 56 · Pre-op care only | $6.17 | $6.61 | $7.08 |
Where Florida sits
The same service costs 5.5 times more in Arkansas 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· 36th of 51
$91.20
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.