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 $776.25 Median $3,890.45 Typical High $12,022.64 | Facility | None | $776.25 | $3,890.45 | $12,022.64 |
Aetna Setting Professional Modifier None Typical Low $3,162.28 Median $3,162.28 Typical High $4,168.69 | Professional | None | $3,162.28 | $3,162.28 | $4,168.69 |
AvMed Setting Facility Modifier None Typical Low $1,445.44 Median $3,388.44 Typical High $12,882.50 | Facility | None | $1,445.44 | $3,388.44 | $12,882.50 |
AvMed Setting Professional Modifier None Typical Low $2,691.53 Median $3,388.44 Typical High $4,073.80 | Professional | None | $2,691.53 | $3,388.44 | $4,073.80 |
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 $2,454.71 Median $3,548.13 Typical High $6,918.31 | Professional | None | $2,454.71 | $3,548.13 | $6,918.31 |
Florida Blue Setting Facility Modifier None Typical Low $2,818.38 Median $5,888.44 Typical High $25,703.96 | Facility | None | $2,818.38 | $5,888.44 | $25,703.96 |
Florida Blue Setting Professional Modifier None Typical Low $2,398.83 Median $2,511.89 Typical High $3,890.45 | Professional | None | $2,398.83 | $2,511.89 | $3,890.45 |
Molina Setting Professional Modifier None Typical Low $245.47 Median $3,019.95 Typical High $4,265.80 | Professional | None | $245.47 | $3,019.95 | $4,265.80 |
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 $3,090.30 Median $4,570.88 Typical High $9,332.54 | Professional | None | $3,090.30 | $4,570.88 | $9,332.54 |
Wellpoint Setting Professional Modifier None Typical Low $2,454.71 Median $2,454.71 Typical High $3,548.13 | Professional | None | $2,454.71 | $2,454.71 | $3,548.13 |
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 $1,548.82 Median $1,584.89 Typical High $2,041.74 | Professional | 52 · Reduced service | $1,548.82 | $1,584.89 | $2,041.74 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $630.96 Median $630.96 Typical High $812.83 | Professional | 53 · Discontinued | $630.96 | $630.96 | $812.83 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $2,344.23 Median $2,398.83 Typical High $3,019.95 | Professional | 54 · Surgery only | $2,344.23 | $2,398.83 | $3,019.95 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $467.74 Median $478.63 Typical High $616.60 | Professional | 55 · Aftercare only | $467.74 | $478.63 | $616.60 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $316.23 Median $316.23 Typical High $407.38 | Professional | 56 · Pre-op care only | $316.23 | $316.23 | $407.38 |
Where Florida sits
The same service costs 7.4 times more in Alaska than in Arkansas. 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· 47th of 51
$3,236
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.