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 $549.54 Median $3,311.31 Typical High $10,964.78 | Facility | None | $549.54 | $3,311.31 | $10,964.78 |
Aetna Setting Professional Modifier None Typical Low $245.47 Median $1,023.29 Typical High $1,621.81 | Professional | None | $245.47 | $1,023.29 | $1,621.81 |
Ambetter Setting Professional Modifier None Typical Low $208.93 Median $208.93 Typical High $446.68 | Professional | None | $208.93 | $208.93 | $446.68 |
AvMed Setting Facility Modifier None Typical Low $1,047.13 Median $5,128.61 Typical High $13,182.57 | Facility | None | $1,047.13 | $5,128.61 | $13,182.57 |
AvMed Setting Professional Modifier None Typical Low $251.19 Median $1,023.29 Typical High $1,445.44 | Professional | None | $251.19 | $1,023.29 | $1,445.44 |
Cigna Setting Facility Modifier None Typical Low $323.59 Median $323.59 Typical High $398.11 | Facility | None | $323.59 | $323.59 | $398.11 |
Cigna Setting Professional Modifier None Typical Low $194.98 Median $891.25 Typical High $2,041.74 | Professional | None | $194.98 | $891.25 | $2,041.74 |
Florida Blue Setting Facility Modifier None Typical Low $4,466.84 Median $8,912.51 Typical High $16,595.87 | Facility | None | $4,466.84 | $8,912.51 | $16,595.87 |
Florida Blue Setting Professional Modifier None Typical Low $831.76 Median $1,348.96 Typical High $1,659.59 | Professional | None | $831.76 | $1,348.96 | $1,659.59 |
Molina Setting Professional Modifier None Typical Low $489.78 Median $1,023.29 Typical High $2,511.89 | Professional | None | $489.78 | $1,023.29 | $2,511.89 |
United Setting Facility Modifier None Typical Low $1,659.59 Median $8,128.31 Typical High $13,182.57 | Facility | None | $1,659.59 | $8,128.31 | $13,182.57 |
United Setting Professional Modifier None Typical Low $239.88 Median $1,000.00 Typical High $2,290.87 | Professional | None | $239.88 | $1,000.00 | $2,290.87 |
Wellpoint Setting Professional Modifier None Typical Low $173.78 Median $954.99 Typical High $954.99 | Professional | None | $173.78 | $954.99 | $954.99 |
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 $123.03 Median $512.86 Typical High $776.25 | Professional | 52 · Reduced service | $123.03 | $512.86 | $776.25 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $48.98 Median $204.17 Typical High $309.03 | Professional | 53 · Discontinued | $48.98 | $204.17 | $309.03 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $186.21 Median $776.25 Typical High $1,148.15 | Professional | 54 · Surgery only | $186.21 | $776.25 | $1,148.15 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $37.15 Median $154.88 Typical High $234.42 | Professional | 55 · Aftercare only | $37.15 | $154.88 | $234.42 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $24.55 Median $102.33 Typical High $154.88 | Professional | 56 · Pre-op care only | $24.55 | $102.33 | $154.88 |
Where Florida sits
The same service costs 4.7 times more in Wisconsin than in Nebraska. 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· 42nd of 51
$977
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.