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 $724.44 Median $3,890.45 Typical High $12,022.64 | Facility | None | $724.44 | $3,890.45 | $12,022.64 |
Aetna Setting Professional Modifier None Typical Low $724.44 Median $741.31 Typical High $977.24 | Professional | None | $724.44 | $741.31 | $977.24 |
AvMed Setting Facility Modifier None Typical Low $630.96 Median $2,137.96 Typical High $11,748.98 | Facility | None | $630.96 | $2,137.96 | $11,748.98 |
AvMed Setting Professional Modifier None Typical Low $616.60 Median $776.25 Typical High $912.01 | Professional | None | $616.60 | $776.25 | $912.01 |
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 $562.34 Median $831.76 Typical High $1,621.81 | Professional | None | $562.34 | $831.76 | $1,621.81 |
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 $537.03 Median $562.34 Typical High $891.25 | Professional | None | $537.03 | $562.34 | $891.25 |
Molina Setting Professional Modifier None Typical Low $588.84 Median $794.33 Typical High $1,096.48 | Professional | None | $588.84 | $794.33 | $1,096.48 |
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 $707.95 Median $1,047.13 Typical High $2,137.96 | Professional | None | $707.95 | $1,047.13 | $2,137.96 |
Wellpoint Setting Professional Modifier None Typical Low $549.54 Median $549.54 Typical High $812.83 | Professional | None | $549.54 | $549.54 | $812.83 |
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 $354.81 Median $371.54 Typical High $457.09 | Professional | 52 · Reduced service | $354.81 | $371.54 | $457.09 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $144.54 Median $147.91 Typical High $181.97 | Professional | 53 · Discontinued | $144.54 | $147.91 | $181.97 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $537.03 Median $549.54 Typical High $691.83 | Professional | 54 · Surgery only | $537.03 | $549.54 | $691.83 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $107.15 Median $109.65 Typical High $138.04 | Professional | 55 · Aftercare only | $107.15 | $109.65 | $138.04 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $72.44 Median $74.13 Typical High $91.20 | Professional | 56 · Pre-op care only | $72.44 | $74.13 | $91.20 |
Where Florida sits
The same service costs 3.8 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· 44th of 51
$891
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.