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 $776.25 Median $5,128.61 Typical High $14,454.40 | Facility | None | $776.25 | $5,128.61 | $14,454.40 |
Aetna Setting Professional Modifier None Typical Low $147.91 Median $645.65 Typical High $2,884.03 | Professional | None | $147.91 | $645.65 | $2,884.03 |
AvMed Setting Facility Modifier None Typical Low $741.31 Median $2,137.96 Typical High $9,772.37 | Facility | None | $741.31 | $2,137.96 | $9,772.37 |
AvMed Setting Professional Modifier None Typical Low $158.49 Median $1,949.84 Typical High $2,511.89 | Professional | None | $158.49 | $1,949.84 | $2,511.89 |
Cigna Setting Facility Modifier None Typical Low $478.63 Median $4,786.30 Typical High $7,413.10 | Facility | None | $478.63 | $4,786.30 | $7,413.10 |
Cigna Setting Professional Modifier None Typical Low $128.82 Median $457.09 Typical High $4,073.80 | Professional | None | $128.82 | $457.09 | $4,073.80 |
Florida Blue Setting Facility Modifier None Typical Low $1,778.28 Median $3,548.13 Typical High $16,982.44 | Facility | None | $1,778.28 | $3,548.13 | $16,982.44 |
Florida Blue Setting Professional Modifier None Typical Low $1,621.81 Median $1,737.80 Typical High $2,884.03 | Professional | None | $1,621.81 | $1,737.80 | $2,884.03 |
Molina Setting Professional Modifier None Typical Low $1,621.81 Median $2,691.53 Typical High $5,248.07 | Professional | None | $1,621.81 | $2,691.53 | $5,248.07 |
United Setting Facility Modifier None Typical Low $1,230.27 Median $3,311.31 Typical High $12,589.25 | Facility | None | $1,230.27 | $3,311.31 | $12,589.25 |
United Setting Professional Modifier None Typical Low $154.88 Median $1,995.26 Typical High $5,011.87 | Professional | None | $154.88 | $1,995.26 | $5,011.87 |
Wellpoint Setting Professional Modifier None Typical Low $117.49 Median $1,862.09 Typical High $1,862.09 | Professional | None | $117.49 | $1,862.09 | $1,862.09 |
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 $72.44 Median $204.17 Typical High $1,380.38 | Professional | 52 · Reduced service | $72.44 | $204.17 | $1,380.38 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $29.51 Median $81.28 Typical High $549.54 | Professional | 53 · Discontinued | $29.51 | $81.28 | $549.54 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $109.65 Median $309.03 Typical High $2,041.74 | Professional | 54 · Surgery only | $109.65 | $309.03 | $2,041.74 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $21.88 Median $61.66 Typical High $416.87 | Professional | 55 · Aftercare only | $21.88 | $61.66 | $416.87 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $14.79 Median $40.74 Typical High $275.42 | Professional | 56 · Pre-op care only | $14.79 | $40.74 | $275.42 |
Where Florida sits
The same service costs 33.1 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· 30th of 51
$2,344
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.