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 $74.13 Median $2,089.30 Typical High $10,715.19 | Facility | None | $74.13 | $2,089.30 | $10,715.19 |
Aetna Setting Professional Modifier None Typical Low $51.29 Median $81.28 Typical High $186.21 | Professional | None | $51.29 | $81.28 | $186.21 |
Ambetter Setting Professional Modifier None Typical Low $91.20 Median $125.89 Typical High $169.82 | Professional | None | $91.20 | $125.89 | $169.82 |
AvMed Setting Facility Modifier None Typical Low $138.04 Median $2,137.96 Typical High $11,748.98 | Facility | None | $138.04 | $2,137.96 | $11,748.98 |
AvMed Setting Professional Modifier None Typical Low $57.54 Median $102.33 Typical High $173.78 | Professional | None | $57.54 | $102.33 | $173.78 |
Cigna Setting Facility Modifier None Typical Low $50.12 Median $66.07 Typical High $724.44 | Facility | None | $50.12 | $66.07 | $724.44 |
Cigna Setting Professional Modifier None Typical Low $43.65 Median $109.65 Typical High $213.80 | Professional | None | $43.65 | $109.65 | $213.80 |
Florida Blue Setting Facility Modifier None Typical Low $34.67 Median $70.79 Typical High $2,137.96 | Facility | None | $34.67 | $70.79 | $2,137.96 |
Florida Blue Setting Professional Modifier None Typical Low $72.44 Median $117.49 Typical High $154.88 | Professional | None | $72.44 | $117.49 | $154.88 |
Molina Setting Professional Modifier None Typical Low $120.23 Median $177.83 Typical High $346.74 | Professional | None | $120.23 | $177.83 | $346.74 |
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 $48.98 Median $102.33 Typical High $223.87 | Professional | None | $48.98 | $102.33 | $223.87 |
Wellpoint Setting Professional Modifier None Typical Low $38.90 Median $117.49 Typical High $117.49 | Professional | None | $38.90 | $117.49 | $117.49 |
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 $40.74 Typical High $72.44 | Professional | 52 · Reduced service | $25.12 | $40.74 | $72.44 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $10.23 Median $16.60 Typical High $28.84 | Professional | 53 · Discontinued | $10.23 | $16.60 | $28.84 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $38.02 Median $61.66 Typical High $109.65 | Professional | 54 · Surgery only | $38.02 | $61.66 | $109.65 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $7.59 Median $12.30 Typical High $21.88 | Professional | 55 · Aftercare only | $7.59 | $12.30 | $21.88 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $5.13 Median $8.13 Typical High $14.45 | Professional | 56 · Pre-op care only | $5.13 | $8.13 | $14.45 |
Where Florida sits
The same service costs 4.0 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· 39th of 51
$115
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.