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 $109.65 Median $3,311.31 Typical High $12,022.64 | Facility | None | $109.65 | $3,311.31 | $12,022.64 |
Aetna Setting Professional Modifier None Typical Low $81.28 Median $107.15 Typical High $134.90 | Professional | None | $81.28 | $107.15 | $134.90 |
AvMed Setting Facility Modifier None Typical Low $112.20 Median $2,137.96 Typical High $12,882.50 | Facility | None | $112.20 | $2,137.96 | $12,882.50 |
AvMed Setting Professional Modifier None Typical Low $91.20 Median $114.82 Typical High $144.54 | Professional | None | $91.20 | $114.82 | $144.54 |
Cigna Setting Facility Modifier None Typical Low $316.23 Median $416.87 Typical High $1,659.59 | Facility | None | $316.23 | $416.87 | $1,659.59 |
Cigna Setting Professional Modifier None Typical Low $67.61 Median $112.20 Typical High $229.09 | Professional | None | $67.61 | $112.20 | $229.09 |
Florida Blue Setting Facility Modifier None Typical Low $208.93 Median $436.52 Typical High $4,466.84 | Facility | None | $208.93 | $436.52 | $4,466.84 |
Florida Blue Setting Professional Modifier None Typical Low $93.33 Median $100.00 Typical High $151.36 | Professional | None | $93.33 | $100.00 | $151.36 |
Molina Setting Professional Modifier None Typical Low $102.33 Median $141.25 Typical High $281.84 | Professional | None | $102.33 | $141.25 | $281.84 |
United Setting Facility Modifier None Typical Low $281.84 Median $660.69 Typical High $4,073.80 | Facility | None | $281.84 | $660.69 | $4,073.80 |
United Setting Professional Modifier None Typical Low $74.13 Median $123.03 Typical High $251.19 | Professional | None | $74.13 | $123.03 | $251.19 |
Wellpoint Setting Professional Modifier None Typical Low $64.57 Median $104.71 Typical High $104.71 | Professional | None | $64.57 | $104.71 | $104.71 |
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 $40.74 Median $53.70 Typical High $66.07 | Professional | 52 · Reduced service | $40.74 | $53.70 | $66.07 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $16.22 Median $21.88 Typical High $26.92 | Professional | 53 · Discontinued | $16.22 | $21.88 | $26.92 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $61.66 Median $81.28 Typical High $100.00 | Professional | 54 · Surgery only | $61.66 | $81.28 | $100.00 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $12.30 Median $16.22 Typical High $19.95 | Professional | 55 · Aftercare only | $12.30 | $16.22 | $19.95 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $8.13 Median $10.72 Typical High $13.49 | Professional | 56 · Pre-op care only | $8.13 | $10.72 | $13.49 |
Where Florida sits
The same service costs 3.5 times more in Alaska than in Indiana. 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· 25th of 51
$170
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.