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 $44.67 Median $48.98 Typical High $60.26 | Professional | None | $44.67 | $48.98 | $60.26 |
AvMed Setting Facility Modifier None Typical Low $42.66 Median $2,137.96 Typical High $11,748.98 | Facility | None | $42.66 | $2,137.96 | $11,748.98 |
AvMed Setting Professional Modifier None Typical Low $33.88 Median $42.66 Typical High $57.54 | Professional | None | $33.88 | $42.66 | $57.54 |
Cigna Setting Facility Modifier None Typical Low $239.88 Median $331.13 Typical High $1,659.59 | Facility | None | $239.88 | $331.13 | $1,659.59 |
Cigna Setting Professional Modifier None Typical Low $35.48 Median $36.31 Typical High $74.13 | Professional | None | $35.48 | $36.31 | $74.13 |
Florida Blue Setting Facility Modifier None Typical Low $123.03 Median $269.15 Typical High $3,981.07 | Facility | None | $123.03 | $269.15 | $3,981.07 |
Florida Blue Setting Professional Modifier None Typical Low $28.18 Median $53.70 Typical High $64.57 | Professional | None | $28.18 | $53.70 | $64.57 |
Molina Setting Professional Modifier None Typical Low $26.92 Median $29.51 Typical High $70.79 | Professional | None | $26.92 | $29.51 | $70.79 |
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 $36.31 Median $47.86 Typical High $79.43 | Professional | None | $36.31 | $47.86 | $79.43 |
Wellpoint Setting Professional Modifier None Typical Low $33.88 Median $33.88 Typical High $33.88 | Professional | None | $33.88 | $33.88 | $33.88 |
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 $22.39 Median $24.55 Typical High $29.51 | Professional | 52 · Reduced service | $22.39 | $24.55 | $29.51 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $8.91 Median $9.77 Typical High $11.75 | Professional | 53 · Discontinued | $8.91 | $9.77 | $11.75 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $33.88 Median $36.31 Typical High $44.67 | Professional | 54 · Surgery only | $33.88 | $36.31 | $44.67 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $6.76 Median $7.24 Typical High $8.91 | Professional | 55 · Aftercare only | $6.76 | $7.24 | $8.91 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $4.47 Median $4.90 Typical High $5.89 | Professional | 56 · Pre-op care only | $4.47 | $4.90 | $5.89 |
Where Florida sits
The same service costs 4.2 times more in Alaska 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
$47.86
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.