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 $478.63 Median $3,715.35 Typical High $10,964.78 | Facility | None | $478.63 | $3,715.35 | $10,964.78 |
Aetna Setting Professional Modifier None Typical Low $114.82 Median $204.17 Typical High $295.12 | Professional | None | $114.82 | $204.17 | $295.12 |
AvMed Setting Facility Modifier None Typical Low $134.90 Median $1,258.93 Typical High $9,549.93 | Facility | None | $134.90 | $1,258.93 | $9,549.93 |
AvMed Setting Professional Modifier None Typical Low $131.83 Median $229.09 Typical High $295.12 | Professional | None | $131.83 | $229.09 | $295.12 |
Cigna Setting Facility Modifier None Typical Low $208.93 Median $398.11 Typical High $2,187.76 | Facility | None | $208.93 | $398.11 | $2,187.76 |
Cigna Setting Professional Modifier None Typical Low $100.00 Median $204.17 Typical High $426.58 | Professional | None | $100.00 | $204.17 | $426.58 |
Florida Blue Setting Facility Modifier None Typical Low $64.57 Median $131.83 Typical High $3,981.07 | Facility | None | $64.57 | $131.83 | $3,981.07 |
Florida Blue Setting Professional Modifier None Typical Low $177.83 Median $194.98 Typical High $257.04 | Professional | None | $177.83 | $194.98 | $257.04 |
Molina Setting Professional Modifier None Typical Low $194.98 Median $281.84 Typical High $549.54 | Professional | None | $194.98 | $281.84 | $549.54 |
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 $104.71 Median $223.87 Typical High $446.68 | Professional | None | $104.71 | $223.87 | $446.68 |
Wellpoint Setting Professional Modifier None Typical Low $93.33 Median $213.80 Typical High $213.80 | Professional | None | $93.33 | $213.80 | $213.80 |
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 $56.23 Median $102.33 Typical High $134.90 | Professional | 52 · Reduced service | $56.23 | $102.33 | $134.90 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $22.91 Median $40.74 Typical High $53.70 | Professional | 53 · Discontinued | $22.91 | $40.74 | $53.70 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $85.11 Median $151.36 Typical High $199.53 | Professional | 54 · Surgery only | $85.11 | $151.36 | $199.53 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $16.98 Median $30.20 Typical High $40.74 | Professional | 55 · Aftercare only | $16.98 | $30.20 | $40.74 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $11.48 Median $20.42 Typical High $26.92 | Professional | 56 · Pre-op care only | $11.48 | $20.42 | $26.92 |
Where Florida sits
The same service costs 3.2 times more in Wisconsin 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· 49th of 51
$224
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.