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 $186.21 Median $3,090.30 Typical High $12,022.64 | Facility | None | $186.21 | $3,090.30 | $12,022.64 |
Aetna Setting Professional Modifier None Typical Low $117.49 Median $173.78 Typical High $257.04 | Professional | None | $117.49 | $173.78 | $257.04 |
AvMed Setting Facility Modifier None Typical Low $177.83 Median $2,137.96 Typical High $11,748.98 | Facility | None | $177.83 | $2,137.96 | $11,748.98 |
AvMed Setting Professional Modifier None Typical Low $158.49 Median $234.42 Typical High $331.13 | Professional | None | $158.49 | $234.42 | $331.13 |
Cigna Setting Facility Modifier None Typical Low $52.48 Median $169.82 Typical High $331.13 | Facility | None | $52.48 | $169.82 | $331.13 |
Cigna Setting Professional Modifier None Typical Low $114.82 Median $190.55 Typical High $316.23 | Professional | None | $114.82 | $190.55 | $316.23 |
Florida Blue Setting Facility Modifier None Typical Low $114.82 Median $251.19 Typical High $3,019.95 | Facility | None | $114.82 | $251.19 | $3,019.95 |
Florida Blue Setting Professional Modifier None Typical Low $87.10 Median $208.93 Typical High $338.84 | Professional | None | $87.10 | $208.93 | $338.84 |
Molina Setting Professional Modifier None Typical Low $131.83 Median $257.04 Typical High $436.52 | Professional | None | $131.83 | $257.04 | $436.52 |
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 $109.65 Median $186.21 Typical High $354.81 | Professional | None | $109.65 | $186.21 | $354.81 |
Wellpoint Setting Professional Modifier None Typical Low $120.23 Median $245.47 Typical High $245.47 | Professional | None | $120.23 | $245.47 | $245.47 |
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 $58.88 Median $85.11 Typical High $125.89 | Professional | 52 · Reduced service | $58.88 | $85.11 | $125.89 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $23.44 Median $34.67 Typical High $50.12 | Professional | 53 · Discontinued | $23.44 | $34.67 | $50.12 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $89.13 Median $128.82 Typical High $186.21 | Professional | 54 · Surgery only | $89.13 | $128.82 | $186.21 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $17.78 Median $25.70 Typical High $37.15 | Professional | 55 · Aftercare only | $17.78 | $25.70 | $37.15 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $11.75 Median $17.38 Typical High $25.12 | Professional | 56 · Pre-op care only | $11.75 | $17.38 | $25.12 |
Where Florida sits
The same service costs 3.6 times more in Alaska than in Maryland. 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· 48th of 51
$191
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.