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 $64.57 Median $3,311.31 Typical High $12,022.64 | Facility | None | $64.57 | $3,311.31 | $12,022.64 |
Aetna Setting Professional Modifier None Typical Low $38.90 Median $53.70 Typical High $77.62 | Professional | None | $38.90 | $53.70 | $77.62 |
AvMed Setting Facility Modifier None Typical Low $60.26 Median $2,137.96 Typical High $11,748.98 | Facility | None | $60.26 | $2,137.96 | $11,748.98 |
AvMed Setting Professional Modifier None Typical Low $45.71 Median $64.57 Typical High $85.11 | Professional | None | $45.71 | $64.57 | $85.11 |
Cigna Setting Facility Modifier None Typical Low $52.48 Median $67.61 Typical High $131.83 | Facility | None | $52.48 | $67.61 | $131.83 |
Cigna Setting Professional Modifier None Typical Low $34.67 Median $52.48 Typical High $95.50 | Professional | None | $34.67 | $52.48 | $95.50 |
Florida Blue Setting Facility Modifier None Typical Low $33.88 Median $67.61 Typical High $2,089.30 | Facility | None | $33.88 | $67.61 | $2,089.30 |
Florida Blue Setting Professional Modifier None Typical Low $25.12 Median $58.88 Typical High $87.10 | Professional | None | $25.12 | $58.88 | $87.10 |
Molina Setting Professional Modifier None Typical Low $77.62 Median $91.20 Typical High $165.96 | Professional | None | $77.62 | $91.20 | $165.96 |
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 $36.31 Median $54.95 Typical High $107.15 | Professional | None | $36.31 | $54.95 | $107.15 |
Wellpoint Setting Professional Modifier None Typical Low $45.71 Median $81.28 Typical High $83.18 | Professional | None | $45.71 | $81.28 | $83.18 |
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 $19.50 Median $26.92 Typical High $36.31 | Professional | 52 · Reduced service | $19.50 | $26.92 | $36.31 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $7.76 Median $10.96 Typical High $14.45 | Professional | 53 · Discontinued | $7.76 | $10.96 | $14.45 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $28.84 Median $40.74 Typical High $53.70 | Professional | 54 · Surgery only | $28.84 | $40.74 | $53.70 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $5.75 Median $8.13 Typical High $10.72 | Professional | 55 · Aftercare only | $5.75 | $8.13 | $10.72 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $3.89 Median $5.37 Typical High $7.24 | Professional | 56 · Pre-op care only | $3.89 | $5.37 | $7.24 |
Where Florida sits
The same service costs 3.6 times more in Alaska 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· 47th of 51
$61.66
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.