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 $380.19 Median $3,090.30 Typical High $10,964.78 | Facility | None | $380.19 | $3,090.30 | $10,964.78 |
Aetna Setting Professional Modifier None Typical Low $70.79 Median $154.88 Typical High $177.83 | Professional | None | $70.79 | $154.88 | $177.83 |
AvMed Setting Facility Modifier None Typical Low $138.04 Median $2,137.96 Typical High $11,748.98 | Facility | None | $138.04 | $2,137.96 | $11,748.98 |
AvMed Setting Professional Modifier None Typical Low $70.79 Median $154.88 Typical High $213.80 | Professional | None | $70.79 | $154.88 | $213.80 |
Cigna Setting Facility Modifier None Typical Low $138.04 Median $288.40 Typical High $2,691.53 | Facility | None | $138.04 | $288.40 | $2,691.53 |
Cigna Setting Professional Modifier None Typical Low $58.88 Median $134.90 Typical High $218.78 | Professional | None | $58.88 | $134.90 | $218.78 |
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 $87.10 Median $186.21 Typical High $223.87 | Professional | None | $87.10 | $186.21 | $223.87 |
Molina Setting Professional Modifier None Typical Low $74.13 Median $138.04 Typical High $338.84 | Professional | None | $74.13 | $138.04 | $338.84 |
United Setting Facility Modifier None Typical Low $398.11 Median $1,000.00 Typical High $5,623.41 | Facility | None | $398.11 | $1,000.00 | $5,623.41 |
United Setting Professional Modifier None Typical Low $64.57 Median $131.83 Typical High $223.87 | Professional | None | $64.57 | $131.83 | $223.87 |
Wellpoint Setting Professional Modifier None Typical Low $56.23 Median $154.88 Typical High $154.88 | Professional | None | $56.23 | $154.88 | $154.88 |
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 $35.48 Median $77.62 Typical High $85.11 | Professional | 52 · Reduced service | $35.48 | $77.62 | $85.11 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $14.45 Median $30.90 Typical High $34.67 | Professional | 53 · Discontinued | $14.45 | $30.90 | $34.67 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $53.70 Median $114.82 Typical High $128.82 | Professional | 54 · Surgery only | $53.70 | $114.82 | $128.82 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $10.72 Median $22.91 Typical High $25.70 | Professional | 55 · Aftercare only | $10.72 | $22.91 | $25.70 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $7.08 Median $15.49 Typical High $16.98 | Professional | 56 · Pre-op care only | $7.08 | $15.49 | $16.98 |
Where Florida sits
The same service costs 3.7 times more in Alaska 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· 46th of 51
$138
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.