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 $338.84 Median $2,951.21 Typical High $10,964.78 | Facility | None | $338.84 | $2,951.21 | $10,964.78 |
Aetna Setting Professional Modifier None Typical Low $64.57 Median $131.83 Typical High $213.80 | Professional | None | $64.57 | $131.83 | $213.80 |
Ambetter Setting Professional Modifier None Typical Low $56.23 Median $95.50 Typical High $416.87 | Professional | None | $56.23 | $95.50 | $416.87 |
AvMed Setting Facility Modifier None Typical Low $162.18 Median $6,025.60 Typical High $13,182.57 | Facility | None | $162.18 | $6,025.60 | $13,182.57 |
AvMed Setting Professional Modifier None Typical Low $66.07 Median $154.88 Typical High $199.53 | Professional | None | $66.07 | $154.88 | $199.53 |
Cigna Setting Facility Modifier None Typical Low $416.87 Median $416.87 Typical High $426.58 | Facility | None | $416.87 | $416.87 | $426.58 |
Cigna Setting Professional Modifier None Typical Low $53.70 Median $134.90 Typical High $302.00 | Professional | None | $53.70 | $134.90 | $302.00 |
Florida Blue Setting Facility Modifier None Typical Low $58.88 Median $177.83 Typical High $177.83 | Facility | None | $58.88 | $177.83 | $177.83 |
Florida Blue Setting Professional Modifier None Typical Low $128.82 Median $213.80 Typical High $346.74 | Professional | None | $128.82 | $213.80 | $346.74 |
Molina Setting Professional Modifier None Typical Low $97.72 Median $134.90 Typical High $338.84 | Professional | None | $97.72 | $134.90 | $338.84 |
United Setting Facility Modifier None Typical Low $169.82 Median $1,819.70 Typical High $5,248.07 | Facility | None | $169.82 | $1,819.70 | $5,248.07 |
United Setting Professional Modifier None Typical Low $61.66 Median $141.25 Typical High $302.00 | Professional | None | $61.66 | $141.25 | $302.00 |
Wellpoint Setting Professional Modifier None Typical Low $50.12 Median $144.54 Typical High $144.54 | Professional | None | $50.12 | $144.54 | $144.54 |
6 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 $32.36 Median $64.57 Typical High $95.50 | Professional | 52 · Reduced service | $32.36 | $64.57 | $95.50 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $12.88 Median $25.70 Typical High $38.02 | Professional | 53 · Discontinued | $12.88 | $25.70 | $38.02 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $48.98 Median $97.72 Typical High $144.54 | Professional | 54 · Surgery only | $48.98 | $97.72 | $144.54 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $9.77 Median $19.50 Typical High $28.84 | Professional | 55 · Aftercare only | $9.77 | $19.50 | $28.84 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $6.46 Median $12.88 Typical High $19.05 | Professional | 56 · Pre-op care only | $6.46 | $12.88 | $19.05 |
Ambetter Setting Professional Modifier 50 · Both sides Typical Low $263.03 Median $263.03 Typical High $263.03 | Professional | 50 · Both sides | $263.03 | $263.03 | $263.03 |
Where Florida sits
The same service costs 3.8 times more in Alaska than in Virginia. 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· 44th of 51
$138
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.