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 $95.50 Median $104.71 Typical High $407.38 | Professional | None | $95.50 | $104.71 | $407.38 |
AvMed Setting Facility Modifier None Typical Low $109.65 Median $6,025.60 Typical High $13,182.57 | Facility | None | $109.65 | $6,025.60 | $13,182.57 |
AvMed Setting Professional Modifier None Typical Low $81.28 Median $104.71 Typical High $131.83 | Professional | None | $81.28 | $104.71 | $131.83 |
Florida Blue Setting Facility Modifier None Typical Low $2,754.23 Median $4,897.79 Typical High $9,332.54 | Facility | None | $2,754.23 | $4,897.79 | $9,332.54 |
Florida Blue Setting Professional Modifier None Typical Low $72.44 Median $74.13 Typical High $97.72 | Professional | None | $72.44 | $74.13 | $97.72 |
Molina Setting Professional Modifier None Typical Low $147.91 Median $154.88 Typical High $181.97 | Professional | None | $147.91 | $154.88 | $181.97 |
United Setting Facility Modifier None Typical Low $575.44 Median $3,630.78 Typical High $6,456.54 | Facility | None | $575.44 | $3,630.78 | $6,456.54 |
United Setting Professional Modifier None Typical Low $97.72 Median $169.82 Typical High $288.40 | Professional | None | $97.72 | $169.82 | $288.40 |
Wellpoint Setting Professional Modifier None Typical Low $102.33 Median $102.33 Typical High $104.71 | Professional | None | $102.33 | $102.33 | $104.71 |
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 $47.86 Median $51.29 Typical High $63.10 | Professional | 52 · Reduced service | $47.86 | $51.29 | $63.10 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $19.05 Median $20.89 Typical High $25.70 | Professional | 53 · Discontinued | $19.05 | $20.89 | $25.70 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $72.44 Median $77.62 Typical High $95.50 | Professional | 54 · Surgery only | $72.44 | $77.62 | $95.50 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $14.45 Median $15.49 Typical High $19.05 | Professional | 55 · Aftercare only | $14.45 | $15.49 | $19.05 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $9.55 Median $10.47 Typical High $12.59 | Professional | 56 · Pre-op care only | $9.55 | $10.47 | $12.59 |
Where Florida sits
The same service costs 37.2 times more in Oklahoma 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· 2nd of 51
$3,890
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.