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 $63.10 Median $67.61 Typical High $812.83 | Facility | None | $63.10 | $67.61 | $812.83 |
Aetna Setting Professional Modifier None Typical Low $66.07 Median $67.61 Typical High $77.62 | Professional | None | $66.07 | $67.61 | $77.62 |
AvMed Setting Facility Modifier None Typical Low $63.10 Median $2,137.96 Typical High $11,748.98 | Facility | None | $63.10 | $2,137.96 | $11,748.98 |
AvMed Setting Professional Modifier None Typical Low $58.88 Median $61.66 Typical High $66.07 | Professional | None | $58.88 | $61.66 | $66.07 |
Cigna Setting Facility Modifier None Typical Low $302.00 Median $1,174.90 Typical High $1,659.59 | Facility | None | $302.00 | $1,174.90 | $1,659.59 |
Cigna Setting Professional Modifier None Typical Low $51.29 Median $72.44 Typical High $138.04 | Professional | None | $51.29 | $72.44 | $138.04 |
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 $44.67 Median $47.86 Typical High $79.43 | Professional | None | $44.67 | $47.86 | $79.43 |
Molina Setting Professional Modifier None Typical Low $26.92 Median $36.31 Typical High $48.98 | Professional | None | $26.92 | $36.31 | $48.98 |
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 $53.70 Median $79.43 Typical High $154.88 | Professional | None | $53.70 | $79.43 | $154.88 |
Wellpoint Setting Professional Modifier None Typical Low $61.66 Median $61.66 Typical High $63.10 | Professional | None | $61.66 | $61.66 | $63.10 |
4 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 $33.11 Median $33.88 Typical High $38.90 | Professional | 52 · Reduced service | $33.11 | $33.88 | $38.90 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $13.49 Median $13.49 Typical High $15.49 | Professional | 53 · Discontinued | $13.49 | $13.49 | $15.49 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $10.00 Median $10.23 Typical High $11.75 | Professional | 55 · Aftercare only | $10.00 | $10.23 | $11.75 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $6.61 Median $6.76 Typical High $7.76 | Professional | 56 · Pre-op care only | $6.61 | $6.76 | $7.76 |
Where Florida sits
The same service costs 4.5 times more in Wisconsin than in Kentucky. 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· 13th of 51
$135
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.