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 $630.96 Median $4,786.30 Typical High $12,022.64 | Facility | None | $630.96 | $4,786.30 | $12,022.64 |
Aetna Setting Professional Modifier None Typical Low $125.89 Median $131.83 Typical High $186.21 | Professional | None | $125.89 | $131.83 | $186.21 |
AvMed Setting Facility Modifier None Typical Low $501.19 Median $2,137.96 Typical High $9,772.37 | Facility | None | $501.19 | $2,137.96 | $9,772.37 |
AvMed Setting Professional Modifier None Typical Low $112.20 Median $151.36 Typical High $177.83 | Professional | None | $112.20 | $151.36 | $177.83 |
Cigna Setting Facility Modifier None Typical Low $512.86 Median $3,162.28 Typical High $17,378.01 | Facility | None | $512.86 | $3,162.28 | $17,378.01 |
Cigna Setting Professional Modifier None Typical Low $102.33 Median $151.36 Typical High $288.40 | Professional | None | $102.33 | $151.36 | $288.40 |
Florida Blue Setting Facility Modifier None Typical Low $1,621.81 Median $3,162.28 Typical High $16,982.44 | Facility | None | $1,621.81 | $3,162.28 | $16,982.44 |
Florida Blue Setting Professional Modifier None Typical Low $93.33 Median $100.00 Typical High $186.21 | Professional | None | $93.33 | $100.00 | $186.21 |
Molina Setting Professional Modifier None Typical Low $112.20 Median $154.88 Typical High $223.87 | Professional | None | $112.20 | $154.88 | $223.87 |
United Setting Facility Modifier None Typical Low $1,584.89 Median $4,073.80 Typical High $14,454.40 | Facility | None | $1,584.89 | $4,073.80 | $14,454.40 |
United Setting Professional Modifier None Typical Low $54.95 Median $165.96 Typical High $346.74 | Professional | None | $54.95 | $165.96 | $346.74 |
Wellpoint Setting Professional Modifier None Typical Low $95.50 Median $95.50 Typical High $141.25 | Professional | None | $95.50 | $95.50 | $141.25 |
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 $63.10 Median $66.07 Typical High $85.11 | Professional | 52 · Reduced service | $63.10 | $66.07 | $85.11 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $25.12 Median $26.30 Typical High $33.88 | Professional | 53 · Discontinued | $25.12 | $26.30 | $33.88 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $95.50 Median $100.00 Typical High $128.82 | Professional | 54 · Surgery only | $95.50 | $100.00 | $128.82 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $19.05 Median $19.95 Typical High $25.70 | Professional | 55 · Aftercare only | $19.05 | $19.95 | $25.70 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $12.59 Median $13.18 Typical High $16.98 | Professional | 56 · Pre-op care only | $12.59 | $13.18 | $16.98 |
Where Florida sits
The same service costs 20.4 times more in Kansas 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· 6th of 51
$1,820
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.