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 $120.23 Median $2,344.23 Typical High $10,715.19 | Facility | None | $120.23 | $2,344.23 | $10,715.19 |
Aetna Setting Professional Modifier None Typical Low $43.65 Median $120.23 Typical High $181.97 | Professional | None | $43.65 | $120.23 | $181.97 |
Ambetter Setting Professional Modifier None Typical Low $41.69 Median $64.57 Typical High $102.33 | Professional | None | $41.69 | $64.57 | $102.33 |
AvMed Setting Facility Modifier None Typical Low $97.72 Median $6,025.60 Typical High $13,182.57 | Facility | None | $97.72 | $6,025.60 | $13,182.57 |
AvMed Setting Professional Modifier None Typical Low $44.67 Median $93.33 Typical High $165.96 | Professional | None | $44.67 | $93.33 | $165.96 |
Cigna Setting Facility Modifier None Typical Low $74.13 Median $74.13 Typical High $74.13 | Facility | None | $74.13 | $74.13 | $74.13 |
Cigna Setting Professional Modifier None Typical Low $35.48 Median $83.18 Typical High $208.93 | Professional | None | $35.48 | $83.18 | $208.93 |
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 $57.54 Median $77.62 Typical High $151.36 | Professional | None | $57.54 | $77.62 | $151.36 |
Molina Setting Professional Modifier None Typical Low $61.66 Median $81.28 Typical High $204.17 | Professional | None | $61.66 | $81.28 | $204.17 |
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 $42.66 Median $104.71 Typical High $229.09 | Professional | None | $42.66 | $104.71 | $229.09 |
Wellpoint Setting Professional Modifier None Typical Low $32.36 Median $87.10 Typical High $87.10 | Professional | None | $32.36 | $87.10 | $87.10 |
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 $21.88 Median $54.95 Typical High $77.62 | Professional | 52 · Reduced service | $21.88 | $54.95 | $77.62 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $8.71 Median $21.88 Typical High $30.90 | Professional | 53 · Discontinued | $8.71 | $21.88 | $30.90 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $33.11 Median $83.18 Typical High $114.82 | Professional | 54 · Surgery only | $33.11 | $83.18 | $114.82 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $6.61 Median $16.60 Typical High $22.91 | Professional | 55 · Aftercare only | $6.61 | $16.60 | $22.91 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $4.37 Median $10.96 Typical High $15.49 | Professional | 56 · Pre-op care only | $4.37 | $10.96 | $15.49 |
Where Florida sits
The same service costs 2.8 times more in Wisconsin than in Florida. 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· 51st of 51
$85.11
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.