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 $354.81 Median $3,019.95 Typical High $10,964.78 | Facility | None | $354.81 | $3,019.95 | $10,964.78 |
Aetna Setting Professional Modifier None Typical Low $81.28 Median $331.13 Typical High $478.63 | Professional | None | $81.28 | $331.13 | $478.63 |
AvMed Setting Facility Modifier None Typical Low $302.00 Median $2,137.96 Typical High $12,882.50 | Facility | None | $302.00 | $2,137.96 | $12,882.50 |
AvMed Setting Professional Modifier None Typical Low $79.43 Median $302.00 Typical High $389.05 | Professional | None | $79.43 | $302.00 | $389.05 |
Cigna Setting Facility Modifier None Typical Low $338.84 Median $537.03 Typical High $17,378.01 | Facility | None | $338.84 | $537.03 | $17,378.01 |
Cigna Setting Professional Modifier None Typical Low $60.26 Median $223.87 Typical High $616.60 | Professional | None | $60.26 | $223.87 | $616.60 |
Florida Blue Setting Facility Modifier None Typical Low $363.08 Median $776.25 Typical High $4,570.88 | Facility | None | $363.08 | $776.25 | $4,570.88 |
Florida Blue Setting Professional Modifier None Typical Low $251.19 Median $263.03 Typical High $436.52 | Professional | None | $251.19 | $263.03 | $436.52 |
Molina Setting Professional Modifier None Typical Low $93.33 Median $398.11 Typical High $549.54 | Professional | None | $93.33 | $398.11 | $549.54 |
United Setting Facility Modifier None Typical Low $281.84 Median $660.69 Typical High $4,897.79 | Facility | None | $281.84 | $660.69 | $4,897.79 |
United Setting Professional Modifier None Typical Low $87.10 Median $309.03 Typical High $758.58 | Professional | None | $87.10 | $309.03 | $758.58 |
Wellpoint Setting Professional Modifier None Typical Low $57.54 Median $281.84 Typical High $281.84 | Professional | None | $57.54 | $281.84 | $281.84 |
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 $40.74 Median $125.89 Typical High $229.09 | Professional | 52 · Reduced service | $40.74 | $125.89 | $229.09 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $16.22 Median $50.12 Typical High $91.20 | Professional | 53 · Discontinued | $16.22 | $50.12 | $91.20 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $60.26 Median $186.21 Typical High $338.84 | Professional | 54 · Surgery only | $60.26 | $186.21 | $338.84 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $12.02 Median $37.15 Typical High $67.61 | Professional | 55 · Aftercare only | $12.02 | $37.15 | $67.61 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $8.13 Median $25.12 Typical High $45.71 | Professional | 56 · Pre-op care only | $8.13 | $25.12 | $45.71 |
Where Florida sits
The same service costs 7.8 times more in Oklahoma 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· 27th of 51
$437
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.