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 $3,019.95 Typical High $10,964.78 | Facility | None | $354.81 | $3,019.95 | $10,964.78 |
Aetna Setting Professional Modifier None Typical Low $43.65 Median $123.03 Typical High $194.98 | Professional | None | $43.65 | $123.03 | $194.98 |
AvMed Setting Facility Modifier None Typical Low $169.82 Median $2,137.96 Typical High $11,748.98 | Facility | None | $169.82 | $2,137.96 | $11,748.98 |
AvMed Setting Professional Modifier None Typical Low $47.86 Median $158.49 Typical High $218.78 | Professional | None | $47.86 | $158.49 | $218.78 |
Cigna Setting Facility Modifier None Typical Low $501.19 Median $2,398.83 Typical High $2,691.53 | Facility | None | $501.19 | $2,398.83 | $2,691.53 |
Cigna Setting Professional Modifier None Typical Low $36.31 Median $125.89 Typical High $218.78 | Professional | None | $36.31 | $125.89 | $218.78 |
Florida Blue Setting Facility Modifier None Typical Low $32.36 Median $53.70 Typical High $97.72 | Facility | None | $32.36 | $53.70 | $97.72 |
Florida Blue Setting Professional Modifier None Typical Low $61.66 Median $151.36 Typical High $302.00 | Professional | None | $61.66 | $151.36 | $302.00 |
Molina Setting Professional Modifier None Typical Low $38.90 Median $169.82 Typical High $295.12 | Professional | None | $38.90 | $169.82 | $295.12 |
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 $38.02 Median $109.65 Typical High $234.42 | Professional | None | $38.02 | $109.65 | $234.42 |
Wellpoint Setting Professional Modifier None Typical Low $35.48 Median $162.18 Typical High $162.18 | Professional | None | $35.48 | $162.18 | $162.18 |
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 $21.88 Median $61.66 Typical High $85.11 | Professional | 52 · Reduced service | $21.88 | $61.66 | $85.11 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $8.71 Median $24.55 Typical High $33.88 | Professional | 53 · Discontinued | $8.71 | $24.55 | $33.88 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $33.11 Median $91.20 Typical High $125.89 | Professional | 54 · Surgery only | $33.11 | $91.20 | $125.89 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $6.61 Median $18.20 Typical High $25.12 | Professional | 55 · Aftercare only | $6.61 | $18.20 | $25.12 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $4.37 Median $12.30 Typical High $16.98 | Professional | 56 · Pre-op care only | $4.37 | $12.30 | $16.98 |
Where Florida sits
The same service costs 4.6 times more in Iowa 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· 34th of 51
$126
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.