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 $54.95 Median $109.65 Typical High $162.18 | Professional | None | $54.95 | $109.65 | $162.18 |
AvMed Setting Facility Modifier None Typical Low $125.89 Median $6,025.60 Typical High $13,182.57 | Facility | None | $125.89 | $6,025.60 | $13,182.57 |
AvMed Setting Professional Modifier None Typical Low $54.95 Median $120.23 Typical High $158.49 | Professional | None | $54.95 | $120.23 | $158.49 |
Cigna Setting Facility Modifier None Typical Low $93.33 Median $93.33 Typical High $93.33 | Facility | None | $93.33 | $93.33 | $93.33 |
Cigna Setting Professional Modifier None Typical Low $45.71 Median $107.15 Typical High $229.09 | Professional | None | $45.71 | $107.15 | $229.09 |
Florida Blue Setting Facility Modifier None Typical Low $1,445.44 Median $1,548.82 Typical High $1,659.59 | Facility | None | $1,445.44 | $1,548.82 | $1,659.59 |
Florida Blue Setting Professional Modifier None Typical Low $77.62 Median $162.18 Typical High $407.38 | Professional | None | $77.62 | $162.18 | $407.38 |
Molina Setting Professional Modifier None Typical Low $69.18 Median $107.15 Typical High $269.15 | Professional | None | $69.18 | $107.15 | $269.15 |
United Setting Facility Modifier None Typical Low $169.82 Median $1,819.70 Typical High $5,248.07 | Facility | None | $169.82 | $1,819.70 | $5,248.07 |
United Setting Professional Modifier None Typical Low $52.48 Median $117.49 Typical High $251.19 | Professional | None | $52.48 | $117.49 | $251.19 |
Wellpoint Setting Professional Modifier None Typical Low $41.69 Median $74.13 Typical High $74.13 | Professional | None | $41.69 | $74.13 | $74.13 |
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 $27.54 Median $54.95 Typical High $77.62 | Professional | 52 · Reduced service | $27.54 | $54.95 | $77.62 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $10.96 Median $21.88 Typical High $31.62 | Professional | 53 · Discontinued | $10.96 | $21.88 | $31.62 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $40.74 Median $81.28 Typical High $117.49 | Professional | 54 · Surgery only | $40.74 | $81.28 | $117.49 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $8.13 Median $16.60 Typical High $23.44 | Professional | 55 · Aftercare only | $8.13 | $16.60 | $23.44 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $5.50 Median $10.96 Typical High $15.85 | Professional | 56 · Pre-op care only | $5.50 | $10.96 | $15.85 |
Where Florida sits
The same service costs 3.7 times more in Wisconsin than in Maryland. 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· 50th of 51
$107
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.