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 $524.81 Median $3,019.95 Typical High $10,964.78 | Facility | None | $524.81 | $3,019.95 | $10,964.78 |
Aetna Setting Professional Modifier None Typical Low $251.19 Median $870.96 Typical High $1,445.44 | Professional | None | $251.19 | $870.96 | $1,445.44 |
Ambetter Setting Professional Modifier None Typical Low $977.24 Median $977.24 Typical High $977.24 | Professional | None | $977.24 | $977.24 | $977.24 |
AvMed Setting Facility Modifier None Typical Low $891.25 Median $6,025.60 Typical High $13,182.57 | Facility | None | $891.25 | $6,025.60 | $13,182.57 |
AvMed Setting Professional Modifier None Typical Low $275.42 Median $891.25 Typical High $1,288.25 | Professional | None | $275.42 | $891.25 | $1,288.25 |
Cigna Setting Facility Modifier None Typical Low $436.52 Median $436.52 Typical High $436.52 | Facility | None | $436.52 | $436.52 | $436.52 |
Cigna Setting Professional Modifier None Typical Low $208.93 Median $724.44 Typical High $1,698.24 | Professional | None | $208.93 | $724.44 | $1,698.24 |
Florida Blue Setting Facility Modifier None Typical Low $51.29 Median $53.70 Typical High $58.88 | Facility | None | $51.29 | $53.70 | $58.88 |
Florida Blue Setting Professional Modifier None Typical Low $295.12 Median $691.83 Typical High $1,288.25 | Professional | None | $295.12 | $691.83 | $1,288.25 |
Molina Setting Professional Modifier None Typical Low $524.81 Median $891.25 Typical High $2,137.96 | Professional | None | $524.81 | $891.25 | $2,137.96 |
United Setting Facility Modifier None Typical Low $169.82 Median $1,819.70 Typical High $5,248.07 | Facility | None | $169.82 | $1,819.70 | $5,248.07 |
United Setting Professional Modifier None Typical Low $229.09 Median $794.33 Typical High $1,862.09 | Professional | None | $229.09 | $794.33 | $1,862.09 |
Wellpoint Setting Professional Modifier None Typical Low $190.55 Median $831.76 Typical High $831.76 | Professional | None | $190.55 | $831.76 | $831.76 |
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 $125.89 Median $426.58 Typical High $645.65 | Professional | 52 · Reduced service | $125.89 | $426.58 | $645.65 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $50.12 Median $169.82 Typical High $257.04 | Professional | 53 · Discontinued | $50.12 | $169.82 | $257.04 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $186.21 Median $630.96 Typical High $977.24 | Professional | 54 · Surgery only | $186.21 | $630.96 | $977.24 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $38.02 Median $125.89 Typical High $194.98 | Professional | 55 · Aftercare only | $38.02 | $125.89 | $194.98 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $25.12 Median $85.11 Typical High $128.82 | Professional | 56 · Pre-op care only | $25.12 | $85.11 | $128.82 |
Where Florida sits
The same service costs 3.5 times more in Wisconsin than in Maryland. 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· 40th of 51
$832
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.