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 $63.10 Median $3,311.31 Typical High $12,022.64 | Facility | None | $63.10 | $3,311.31 | $12,022.64 |
Aetna Setting Professional Modifier None Typical Low $50.12 Median $63.10 Typical High $93.33 | Professional | None | $50.12 | $63.10 | $93.33 |
AvMed Setting Facility Modifier None Typical Low $77.62 Median $2,137.96 Typical High $11,748.98 | Facility | None | $77.62 | $2,137.96 | $11,748.98 |
AvMed Setting Professional Modifier None Typical Low $66.07 Median $89.13 Typical High $120.23 | Professional | None | $66.07 | $89.13 | $120.23 |
Cigna Setting Facility Modifier None Typical Low $52.48 Median $87.10 Typical High $169.82 | Facility | None | $52.48 | $87.10 | $169.82 |
Cigna Setting Professional Modifier None Typical Low $50.12 Median $70.79 Typical High $120.23 | Professional | None | $50.12 | $70.79 | $120.23 |
Florida Blue Setting Facility Modifier None Typical Low $34.67 Median $70.79 Typical High $3,019.95 | Facility | None | $34.67 | $70.79 | $3,019.95 |
Florida Blue Setting Professional Modifier None Typical Low $34.67 Median $83.18 Typical High $123.03 | Professional | None | $34.67 | $83.18 | $123.03 |
Molina Setting Professional Modifier None Typical Low $57.54 Median $87.10 Typical High $144.54 | Professional | None | $57.54 | $87.10 | $144.54 |
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 $50.12 Median $69.18 Typical High $138.04 | Professional | None | $50.12 | $69.18 | $138.04 |
Wellpoint Setting Professional Modifier None Typical Low $52.48 Median $87.10 Typical High $87.10 | Professional | None | $52.48 | $87.10 | $87.10 |
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 $25.12 Median $31.62 Typical High $46.77 | Professional | 52 · Reduced service | $25.12 | $31.62 | $46.77 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $10.00 Median $12.88 Typical High $18.62 | Professional | 53 · Discontinued | $10.00 | $12.88 | $18.62 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $37.15 Median $47.86 Typical High $69.18 | Professional | 54 · Surgery only | $37.15 | $47.86 | $69.18 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $7.41 Median $9.55 Typical High $13.80 | Professional | 55 · Aftercare only | $7.41 | $9.55 | $13.80 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $5.01 Median $6.31 Typical High $9.33 | Professional | 56 · Pre-op care only | $5.01 | $6.31 | $9.33 |
Where Florida sits
The same service costs 3.8 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
$74.13
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.