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 $575.44 Median $3,090.30 Typical High $12,022.64 | Facility | None | $575.44 | $3,090.30 | $12,022.64 |
Aetna Setting Professional Modifier None Typical Low $309.03 Median $1,348.96 Typical High $2,630.27 | Professional | None | $309.03 | $1,348.96 | $2,630.27 |
Ambetter Setting Professional Modifier None Typical Low $165.96 Median $208.93 Typical High $316.23 | Professional | None | $165.96 | $208.93 | $316.23 |
AvMed Setting Facility Modifier None Typical Low $933.25 Median $5,128.61 Typical High $13,182.57 | Facility | None | $933.25 | $5,128.61 | $13,182.57 |
AvMed Setting Professional Modifier None Typical Low $380.19 Median $1,905.46 Typical High $2,454.71 | Professional | None | $380.19 | $1,905.46 | $2,454.71 |
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 $288.40 Median $1,288.25 Typical High $2,884.03 | Professional | None | $288.40 | $1,288.25 | $2,884.03 |
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 $1,071.52 Median $1,778.28 Typical High $2,137.96 | Professional | None | $1,071.52 | $1,778.28 | $2,137.96 |
Molina Setting Professional Modifier None Typical Low $707.95 Median $1,862.09 Typical High $4,570.88 | Professional | None | $707.95 | $1,862.09 | $4,570.88 |
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 $1,318.26 Typical High $3,019.95 | Professional | None | $331.13 | $1,318.26 | $3,019.95 |
Wellpoint Setting Professional Modifier None Typical Low $257.04 Median $1,659.59 Typical High $1,659.59 | Professional | None | $257.04 | $1,659.59 | $1,659.59 |
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 $676.08 Typical High $1,071.52 | Professional | 52 · Reduced service | $154.88 | $676.08 | $1,071.52 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $61.66 Median $295.12 Typical High $426.58 | Professional | 53 · Discontinued | $61.66 | $295.12 | $426.58 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $234.42 Median $1,000.00 Typical High $1,621.81 | Professional | 54 · Surgery only | $234.42 | $1,000.00 | $1,621.81 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $46.77 Median $218.78 Typical High $323.59 | Professional | 55 · Aftercare only | $46.77 | $218.78 | $323.59 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $30.90 Median $147.91 Typical High $213.80 | Professional | 56 · Pre-op care only | $30.90 | $147.91 | $213.80 |
Ambetter Setting Professional Modifier 50 · Both sides Typical Low $316.23 Median $501.19 Typical High $758.58 | Professional | 50 · Both sides | $316.23 | $501.19 | $758.58 |
Where Florida sits
The same service costs 6.2 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· 35th of 51
$1,660
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.