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 $407.38 Median $3,090.30 Typical High $11,481.54 | Facility | None | $407.38 | $3,090.30 | $11,481.54 |
Aetna Setting Professional Modifier None Typical Low $69.18 Median $75.86 Typical High $95.50 | Professional | None | $69.18 | $75.86 | $95.50 |
AvMed Setting Facility Modifier None Typical Low $63.10 Median $2,137.96 Typical High $13,182.57 | Facility | None | $63.10 | $2,137.96 | $13,182.57 |
AvMed Setting Professional Modifier None Typical Low $58.88 Median $77.62 Typical High $102.33 | Professional | None | $58.88 | $77.62 | $102.33 |
Cigna Setting Facility Modifier None Typical Low $398.11 Median $501.19 Typical High $2,691.53 | Facility | None | $398.11 | $501.19 | $2,691.53 |
Cigna Setting Professional Modifier None Typical Low $54.95 Median $81.28 Typical High $162.18 | Professional | None | $54.95 | $81.28 | $162.18 |
Florida Blue Setting Facility Modifier None Typical Low $10,471.29 Median $22,387.21 Typical High $33,884.42 | Facility | None | $10,471.29 | $22,387.21 | $33,884.42 |
Florida Blue Setting Professional Modifier None Typical Low $50.12 Median $53.70 Typical High $114.82 | Professional | None | $50.12 | $53.70 | $114.82 |
Molina Setting Professional Modifier None Typical Low $53.70 Median $74.13 Typical High $141.25 | Professional | None | $53.70 | $74.13 | $141.25 |
United Setting Facility Modifier None Typical Low $371.54 Median $954.99 Typical High $7,585.78 | Facility | None | $371.54 | $954.99 | $7,585.78 |
United Setting Professional Modifier None Typical Low $58.88 Median $91.20 Typical High $177.83 | Professional | None | $58.88 | $91.20 | $177.83 |
Wellpoint Setting Professional Modifier None Typical Low $54.95 Median $54.95 Typical High $72.44 | Professional | None | $54.95 | $54.95 | $72.44 |
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 $34.67 Median $35.48 Typical High $45.71 | Professional | 52 · Reduced service | $34.67 | $35.48 | $45.71 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $13.80 Median $14.13 Typical High $18.62 | Professional | 53 · Discontinued | $13.80 | $14.13 | $18.62 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $51.29 Median $53.70 Typical High $69.18 | Professional | 54 · Surgery only | $51.29 | $53.70 | $69.18 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $10.47 Median $10.72 Typical High $13.80 | Professional | 55 · Aftercare only | $10.47 | $10.72 | $13.80 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $6.92 Median $7.08 Typical High $9.12 | Professional | 56 · Pre-op care only | $6.92 | $7.08 | $9.12 |
Where Florida sits
The same service costs 6.5 times more in Tennessee than in New York. 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· 26th of 51
$135
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.