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 $117.49 Median $190.55 Typical High $309.03 | Professional | None | $117.49 | $190.55 | $309.03 |
AvMed Setting Facility Modifier None Typical Low $234.42 Median $1,174.90 Typical High $9,549.93 | Facility | None | $234.42 | $1,174.90 | $9,549.93 |
AvMed Setting Professional Modifier None Typical Low $138.04 Median $234.42 Typical High $295.12 | Professional | None | $138.04 | $234.42 | $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 $102.33 Median $204.17 Typical High $426.58 | Professional | None | $102.33 | $204.17 | $426.58 |
Florida Blue Setting Facility Modifier None Typical Low $199.53 Median $436.52 Typical High $3,981.07 | Facility | None | $199.53 | $436.52 | $3,981.07 |
Florida Blue Setting Professional Modifier None Typical Low $165.96 Median $208.93 Typical High $263.03 | Professional | None | $165.96 | $208.93 | $263.03 |
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 $109.65 Median $223.87 Typical High $457.09 | Professional | None | $109.65 | $223.87 | $457.09 |
Wellpoint Setting Professional Modifier None Typical Low $93.33 Median $218.78 Typical High $218.78 | Professional | None | $93.33 | $218.78 | $218.78 |
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 $58.88 Median $95.50 Typical High $134.90 | Professional | 52 · Reduced service | $58.88 | $95.50 | $134.90 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $23.44 Median $38.02 Typical High $54.95 | Professional | 53 · Discontinued | $23.44 | $38.02 | $54.95 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $89.13 Median $141.25 Typical High $204.17 | Professional | 54 · Surgery only | $89.13 | $141.25 | $204.17 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $17.78 Median $28.18 Typical High $40.74 | Professional | 55 · Aftercare only | $17.78 | $28.18 | $40.74 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $11.75 Median $19.05 Typical High $26.92 | Professional | 56 · Pre-op care only | $11.75 | $19.05 | $26.92 |
Where Florida sits
The same service costs 3.1 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· 39th of 51
$257
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.