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 $645.65 Median $5,495.41 Typical High $12,022.64 | Facility | None | $645.65 | $5,495.41 | $12,022.64 |
Aetna Setting Professional Modifier None Typical Low $186.21 Median $234.42 Typical High $537.03 | Professional | None | $186.21 | $234.42 | $537.03 |
AvMed Setting Facility Modifier None Typical Low $398.11 Median $2,818.38 Typical High $11,748.98 | Facility | None | $398.11 | $2,818.38 | $11,748.98 |
AvMed Setting Professional Modifier None Typical Low $269.15 Median $354.81 Typical High $478.63 | Professional | None | $269.15 | $354.81 | $478.63 |
Cigna Setting Facility Modifier None Typical Low $501.19 Median $2,951.21 Typical High $5,370.32 | Facility | None | $501.19 | $2,951.21 | $5,370.32 |
Cigna Setting Professional Modifier None Typical Low $302.00 Median $380.19 Typical High $812.83 | Professional | None | $302.00 | $380.19 | $812.83 |
Florida Blue Setting Facility Modifier None Typical Low $1,737.80 Median $3,548.13 Typical High $16,982.44 | Facility | None | $1,737.80 | $3,548.13 | $16,982.44 |
Florida Blue Setting Professional Modifier None Typical Low $190.55 Median $288.40 Typical High $371.54 | Professional | None | $190.55 | $288.40 | $371.54 |
Molina Setting Professional Modifier None Typical Low $302.00 Median $416.87 Typical High $776.25 | Professional | None | $302.00 | $416.87 | $776.25 |
United Setting Facility Modifier None Typical Low $794.33 Median $1,778.28 Typical High $7,585.78 | Facility | None | $794.33 | $1,778.28 | $7,585.78 |
United Setting Professional Modifier None Typical Low $60.26 Median $426.58 Typical High $758.58 | Professional | None | $60.26 | $426.58 | $758.58 |
Wellpoint Setting Professional Modifier None Typical Low $275.42 Median $275.42 Typical High $398.11 | Professional | None | $275.42 | $275.42 | $398.11 |
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 $93.33 Median $109.65 Typical High $257.04 | Professional | 52 · Reduced service | $93.33 | $109.65 | $257.04 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $37.15 Median $43.65 Typical High $102.33 | Professional | 53 · Discontinued | $37.15 | $43.65 | $102.33 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $138.04 Median $165.96 Typical High $380.19 | Professional | 54 · Surgery only | $138.04 | $165.96 | $380.19 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $27.54 Median $33.11 Typical High $77.62 | Professional | 55 · Aftercare only | $27.54 | $33.11 | $77.62 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $18.62 Median $21.88 Typical High $51.29 | Professional | 56 · Pre-op care only | $18.62 | $21.88 | $51.29 |
Where Florida sits
The same service costs 5.2 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· 14th of 51
$794
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.