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 $213.80 Median $229.09 Typical High $288.40 | Professional | None | $213.80 | $229.09 | $288.40 |
AvMed Setting Facility Modifier None Typical Low $218.78 Median $2,137.96 Typical High $11,748.98 | Facility | None | $218.78 | $2,137.96 | $11,748.98 |
AvMed Setting Professional Modifier None Typical Low $186.21 Median $234.42 Typical High $275.42 | Professional | None | $186.21 | $234.42 | $275.42 |
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 $169.82 Median $257.04 Typical High $512.86 | Professional | None | $169.82 | $257.04 | $512.86 |
Florida Blue Setting Facility Modifier None Typical Low $10,000.00 Median $21,877.62 Typical High $33,884.42 | Facility | None | $10,000.00 | $21,877.62 | $33,884.42 |
Florida Blue Setting Professional Modifier None Typical Low $162.18 Median $169.82 Typical High $288.40 | Professional | None | $162.18 | $169.82 | $288.40 |
Molina Setting Professional Modifier None Typical Low $165.96 Median $229.09 Typical High $316.23 | Professional | None | $165.96 | $229.09 | $316.23 |
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 $213.80 Median $323.59 Typical High $645.65 | Professional | None | $213.80 | $323.59 | $645.65 |
Wellpoint Setting Professional Modifier None Typical Low $169.82 Median $169.82 Typical High $245.47 | Professional | None | $169.82 | $169.82 | $245.47 |
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 $107.15 Median $114.82 Typical High $138.04 | Professional | 52 · Reduced service | $107.15 | $114.82 | $138.04 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $42.66 Median $45.71 Typical High $54.95 | Professional | 53 · Discontinued | $42.66 | $45.71 | $54.95 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $158.49 Median $173.78 Typical High $208.93 | Professional | 54 · Surgery only | $158.49 | $173.78 | $208.93 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $31.62 Median $34.67 Typical High $41.69 | Professional | 55 · Aftercare only | $31.62 | $34.67 | $41.69 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $21.38 Median $22.91 Typical High $27.54 | Professional | 56 · Pre-op care only | $21.38 | $22.91 | $27.54 |
Where Florida sits
The same service costs 4.0 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· 17th of 51
$437
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.