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 $537.03 Median $3,090.30 Typical High $12,022.64 | Facility | None | $537.03 | $3,090.30 | $12,022.64 |
Aetna Setting Professional Modifier None Typical Low $309.03 Median $1,380.38 Typical High $2,691.53 | Professional | None | $309.03 | $1,380.38 | $2,691.53 |
Ambetter Setting Professional Modifier None Typical Low $169.82 Median $169.82 Typical High $467.74 | Professional | None | $169.82 | $169.82 | $467.74 |
AvMed Setting Facility Modifier None Typical Low $1,288.25 Median $5,128.61 Typical High $13,182.57 | Facility | None | $1,288.25 | $5,128.61 | $13,182.57 |
AvMed Setting Professional Modifier None Typical Low $389.05 Median $1,949.84 Typical High $2,511.89 | Professional | None | $389.05 | $1,949.84 | $2,511.89 |
Cigna Setting Facility Modifier None Typical Low $323.59 Median $323.59 Typical High $588.84 | Facility | None | $323.59 | $323.59 | $588.84 |
Cigna Setting Professional Modifier None Typical Low $295.12 Median $1,258.93 Typical High $3,019.95 | Professional | None | $295.12 | $1,258.93 | $3,019.95 |
Florida Blue Setting Facility Modifier None Typical Low $6,456.54 Median $13,489.63 Typical High $23,442.29 | Facility | None | $6,456.54 | $13,489.63 | $23,442.29 |
Florida Blue Setting Professional Modifier None Typical Low $1,047.13 Median $1,778.28 Typical High $2,089.30 | Professional | None | $1,047.13 | $1,778.28 | $2,089.30 |
Molina Setting Professional Modifier None Typical Low $724.44 Median $1,949.84 Typical High $4,677.35 | Professional | None | $724.44 | $1,949.84 | $4,677.35 |
United Setting Facility Modifier None Typical Low $3,235.94 Median $12,882.50 Typical High $21,877.62 | Facility | None | $3,235.94 | $12,882.50 | $21,877.62 |
United Setting Professional Modifier None Typical Low $331.13 Median $1,348.96 Typical High $3,162.28 | Professional | None | $331.13 | $1,348.96 | $3,162.28 |
Wellpoint Setting Professional Modifier None Typical Low $257.04 Median $1,698.24 Typical High $1,698.24 | Professional | None | $257.04 | $1,698.24 | $1,698.24 |
6 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 $154.88 Median $691.83 Typical High $1,096.48 | Professional | 52 · Reduced service | $154.88 | $691.83 | $1,096.48 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $61.66 Median $275.42 Typical High $436.52 | Professional | 53 · Discontinued | $61.66 | $275.42 | $436.52 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $234.42 Median $1,023.29 Typical High $1,659.59 | Professional | 54 · Surgery only | $234.42 | $1,023.29 | $1,659.59 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $46.77 Median $204.17 Typical High $331.13 | Professional | 55 · Aftercare only | $46.77 | $204.17 | $331.13 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $30.90 Median $138.04 Typical High $218.78 | Professional | 56 · Pre-op care only | $30.90 | $138.04 | $218.78 |
Ambetter Setting Professional Modifier 50 · Both sides Typical Low $316.23 Median $707.95 Typical High $977.24 | Professional | 50 · Both sides | $316.23 | $707.95 | $977.24 |
Where Florida sits
The same service costs 6.3 times more in Washington 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· 29th of 51
$1,698
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.