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 $407.38 Median $3,090.30 Typical High $11,481.54 | Facility | None | $407.38 | $3,090.30 | $11,481.54 |
Aetna Setting Professional Modifier None Typical Low $33.88 Median $35.48 Typical High $54.95 | Professional | None | $33.88 | $35.48 | $54.95 |
Ambetter Setting Professional Modifier None Typical Low $39.81 Median $39.81 Typical High $39.81 | Professional | None | $39.81 | $39.81 | $39.81 |
AvMed Setting Facility Modifier None Typical Low $28.18 Median $2,137.96 Typical High $4,897.79 | Facility | None | $28.18 | $2,137.96 | $4,897.79 |
AvMed Setting Professional Modifier None Typical Low $28.18 Median $38.02 Typical High $44.67 | Professional | None | $28.18 | $38.02 | $44.67 |
Cigna Setting Facility Modifier None Typical Low $50.12 Median $66.07 Typical High $724.44 | Facility | None | $50.12 | $66.07 | $724.44 |
Cigna Setting Professional Modifier None Typical Low $28.18 Median $41.69 Typical High $79.43 | Professional | None | $28.18 | $41.69 | $79.43 |
Florida Blue Setting Facility Modifier None Typical Low $34.67 Median $74.13 Typical High $3,981.07 | Facility | None | $34.67 | $74.13 | $3,981.07 |
Florida Blue Setting Professional Modifier None Typical Low $23.99 Median $25.12 Typical High $125.89 | Professional | None | $23.99 | $25.12 | $125.89 |
Molina Setting Professional Modifier None Typical Low $26.92 Median $37.15 Typical High $51.29 | Professional | None | $26.92 | $37.15 | $51.29 |
United Setting Facility Modifier None Typical Low $81.28 Median $302.00 Typical High $2,818.38 | Facility | None | $81.28 | $302.00 | $2,818.38 |
United Setting Professional Modifier None Typical Low $33.11 Median $48.98 Typical High $102.33 | Professional | None | $33.11 | $48.98 | $102.33 |
Wellpoint Setting Professional Modifier None Typical Low $26.92 Median $26.92 Typical High $35.48 | Professional | None | $26.92 | $26.92 | $35.48 |
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 $16.98 Median $17.78 Typical High $23.99 | Professional | 52 · Reduced service | $16.98 | $17.78 | $23.99 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $6.76 Median $7.24 Typical High $9.55 | Professional | 53 · Discontinued | $6.76 | $7.24 | $9.55 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $25.70 Median $26.92 Typical High $36.31 | Professional | 54 · Surgery only | $25.70 | $26.92 | $36.31 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $5.13 Median $5.37 Typical High $7.24 | Professional | 55 · Aftercare only | $5.13 | $5.37 | $7.24 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $3.39 Median $3.63 Typical High $4.79 | Professional | 56 · Pre-op care only | $3.39 | $3.63 | $4.79 |
Where Florida sits
The same service costs 9.3 times more in Tennessee than in New York. 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· 30th of 51
$64.57
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.