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 $3,890.45 Typical High $12,022.64 | Facility | None | $645.65 | $3,890.45 | $12,022.64 |
Aetna Setting Professional Modifier None Typical Low $263.03 Median $269.15 Typical High $630.96 | Professional | None | $263.03 | $269.15 | $630.96 |
AvMed Setting Facility Modifier None Typical Low $263.03 Median $2,137.96 Typical High $11,748.98 | Facility | None | $263.03 | $2,137.96 | $11,748.98 |
AvMed Setting Professional Modifier None Typical Low $234.42 Median $309.03 Typical High $354.81 | Professional | None | $234.42 | $309.03 | $354.81 |
Cigna Setting Facility Modifier None Typical Low $457.09 Median $2,137.96 Typical High $2,754.23 | Facility | None | $457.09 | $2,137.96 | $2,754.23 |
Cigna Setting Professional Modifier None Typical Low $208.93 Median $309.03 Typical High $616.60 | Professional | None | $208.93 | $309.03 | $616.60 |
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 $194.98 Median $204.17 Typical High $354.81 | Professional | None | $194.98 | $204.17 | $354.81 |
Molina Setting Professional Modifier None Typical Low $194.98 Median $263.03 Typical High $363.08 | Professional | None | $194.98 | $263.03 | $363.08 |
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 $54.95 Median $338.84 Typical High $758.58 | Professional | None | $54.95 | $338.84 | $758.58 |
Wellpoint Setting Professional Modifier None Typical Low $199.53 Median $199.53 Typical High $295.12 | Professional | None | $199.53 | $199.53 | $295.12 |
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 $131.83 Median $134.90 Typical High $173.78 | Professional | 52 · Reduced service | $131.83 | $134.90 | $173.78 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $52.48 Median $53.70 Typical High $69.18 | Professional | 53 · Discontinued | $52.48 | $53.70 | $69.18 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $194.98 Median $204.17 Typical High $263.03 | Professional | 54 · Surgery only | $194.98 | $204.17 | $263.03 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $38.90 Median $40.74 Typical High $52.48 | Professional | 55 · Aftercare only | $38.90 | $40.74 | $52.48 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $26.30 Median $26.92 Typical High $34.67 | Professional | 56 · Pre-op care only | $26.30 | $26.92 | $34.67 |
Where Florida sits
The same service costs 3.9 times more in Wisconsin 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· 27th of 51
$447
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.