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 $407.38 Median $3,090.30 Typical High $11,481.54 | Facility | None | $407.38 | $3,090.30 | $11,481.54 |
Aetna Setting Professional Modifier None Typical Low $309.03 Median $346.74 Typical High $416.87 | Professional | None | $309.03 | $346.74 | $416.87 |
AvMed Setting Facility Modifier None Typical Low $1,318.26 Median $4,466.84 Typical High $13,182.57 | Facility | None | $1,318.26 | $4,466.84 | $13,182.57 |
Cigna Setting Facility Modifier None Typical Low $457.09 Median $2,691.53 Typical High $16,595.87 | Facility | None | $457.09 | $2,691.53 | $16,595.87 |
Cigna Setting Professional Modifier None Typical Low $281.84 Median $302.00 Typical High $602.56 | Professional | None | $281.84 | $302.00 | $602.56 |
Florida Blue Setting Professional Modifier None Typical Low $144.54 Median $281.84 Typical High $416.87 | Professional | None | $144.54 | $281.84 | $416.87 |
United Setting Facility Modifier None Typical Low $81.28 Median $302.00 Typical High $3,311.31 | Facility | None | $81.28 | $302.00 | $3,311.31 |
United Setting Professional Modifier None Typical Low $251.19 Median $331.13 Typical High $660.69 | Professional | None | $251.19 | $331.13 | $660.69 |
Wellpoint Setting Professional Modifier None Typical Low $467.74 Median $467.74 Typical High $467.74 | Professional | None | $467.74 | $467.74 | $467.74 |
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 $154.88 Median $173.78 Typical High $208.93 | Professional | 52 · Reduced service | $154.88 | $173.78 | $208.93 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $61.66 Median $69.18 Typical High $83.18 | Professional | 53 · Discontinued | $61.66 | $69.18 | $83.18 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $229.09 Median $263.03 Typical High $309.03 | Professional | 54 · Surgery only | $229.09 | $263.03 | $309.03 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $46.77 Median $52.48 Typical High $63.10 | Professional | 55 · Aftercare only | $46.77 | $52.48 | $63.10 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $30.90 Median $34.67 Typical High $41.69 | Professional | 56 · Pre-op care only | $30.90 | $34.67 | $41.69 |
Where Florida sits
The same service costs 4.6 times more in Alaska than in Florida. 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· 51st of 51
$347
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.