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 $40.74 Median $1,737.80 Typical High $10,471.29 | Facility | None | $40.74 | $1,737.80 | $10,471.29 |
Aetna Setting Professional Modifier None Typical Low $30.20 Median $41.69 Typical High $67.61 | Professional | None | $30.20 | $41.69 | $67.61 |
Ambetter Setting Professional Modifier None Typical Low $34.67 Median $48.98 Typical High $53.70 | Professional | None | $34.67 | $48.98 | $53.70 |
AvMed Setting Facility Modifier None Typical Low $39.81 Median $2,137.96 Typical High $11,748.98 | Facility | None | $39.81 | $2,137.96 | $11,748.98 |
AvMed Setting Professional Modifier None Typical Low $36.31 Median $43.65 Typical High $57.54 | Professional | None | $36.31 | $43.65 | $57.54 |
Cigna Setting Facility Modifier None Typical Low $27.54 Median $57.54 Typical High $1,659.59 | Facility | None | $27.54 | $57.54 | $1,659.59 |
Cigna Setting Professional Modifier None Typical Low $26.30 Median $38.02 Typical High $69.18 | Professional | None | $26.30 | $38.02 | $69.18 |
Florida Blue Setting Facility Modifier None Typical Low $32.36 Median $69.18 Typical High $3,019.95 | Facility | None | $32.36 | $69.18 | $3,019.95 |
Florida Blue Setting Professional Modifier None Typical Low $19.05 Median $45.71 Typical High $66.07 | Professional | None | $19.05 | $45.71 | $66.07 |
Molina Setting Professional Modifier None Typical Low $30.90 Median $54.95 Typical High $95.50 | Professional | None | $30.90 | $54.95 | $95.50 |
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 $28.18 Median $39.81 Typical High $79.43 | Professional | None | $28.18 | $39.81 | $79.43 |
Wellpoint Setting Professional Modifier None Typical Low $27.54 Median $39.81 Typical High $39.81 | Professional | None | $27.54 | $39.81 | $39.81 |
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 $15.14 Median $20.42 Typical High $25.70 | Professional | 52 · Reduced service | $15.14 | $20.42 | $25.70 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $6.03 Median $8.13 Typical High $10.47 | Professional | 53 · Discontinued | $6.03 | $8.13 | $10.47 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $22.39 Median $30.90 Typical High $38.90 | Professional | 54 · Surgery only | $22.39 | $30.90 | $38.90 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $4.47 Median $6.17 Typical High $7.76 | Professional | 55 · Aftercare only | $4.47 | $6.17 | $7.76 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $3.02 Median $4.07 Typical High $5.13 | Professional | 56 · Pre-op care only | $3.02 | $4.07 | $5.13 |
Where Florida sits
The same service costs 4.2 times more in Alaska than in New York. 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· 50th of 51
$44.67
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.