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 $354.81 Median $2,951.21 Typical High $10,964.78 | Facility | None | $354.81 | $2,951.21 | $10,964.78 |
Aetna Setting Professional Modifier None Typical Low $70.79 Median $177.83 Typical High $331.13 | Professional | None | $70.79 | $177.83 | $331.13 |
Ambetter Setting Professional Modifier None Typical Low $302.00 Median $302.00 Typical High $331.13 | Professional | None | $302.00 | $302.00 | $331.13 |
AvMed Setting Facility Modifier None Typical Low $275.42 Median $6,025.60 Typical High $13,182.57 | Facility | None | $275.42 | $6,025.60 | $13,182.57 |
AvMed Setting Professional Modifier None Typical Low $75.86 Median $239.88 Typical High $338.84 | Professional | None | $75.86 | $239.88 | $338.84 |
Cigna Setting Facility Modifier None Typical Low $125.89 Median $125.89 Typical High $125.89 | Facility | None | $125.89 | $125.89 | $125.89 |
Cigna Setting Professional Modifier None Typical Low $61.66 Median $213.80 Typical High $446.68 | Professional | None | $61.66 | $213.80 | $446.68 |
Florida Blue Setting Facility Modifier None Typical Low $58.88 Median $263.03 Typical High $263.03 | Facility | None | $58.88 | $263.03 | $263.03 |
Florida Blue Setting Professional Modifier None Typical Low $190.55 Median $309.03 Typical High $371.54 | Professional | None | $190.55 | $309.03 | $371.54 |
Molina Setting Professional Modifier None Typical Low $100.00 Median $245.47 Typical High $602.56 | Professional | None | $100.00 | $245.47 | $602.56 |
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 $69.18 Median $190.55 Typical High $446.68 | Professional | None | $69.18 | $190.55 | $446.68 |
Wellpoint Setting Professional Modifier None Typical Low $56.23 Median $120.23 Typical High $120.23 | Professional | None | $56.23 | $120.23 | $120.23 |
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 $33.88 Median $87.10 Typical High $151.36 | Professional | 52 · Reduced service | $33.88 | $87.10 | $151.36 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $13.49 Median $35.48 Typical High $60.26 | Professional | 53 · Discontinued | $13.49 | $35.48 | $60.26 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $51.29 Median $131.83 Typical High $229.09 | Professional | 54 · Surgery only | $51.29 | $131.83 | $229.09 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $10.23 Median $26.30 Typical High $45.71 | Professional | 55 · Aftercare only | $10.23 | $26.30 | $45.71 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $6.76 Median $17.38 Typical High $30.20 | Professional | 56 · Pre-op care only | $6.76 | $17.38 | $30.20 |
Where Florida sits
The same service costs 4.2 times more in Washington 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· 33rd of 51
$219
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.