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 $74.13 Median $263.03 Typical High $338.84 | Professional | None | $74.13 | $263.03 | $338.84 |
AvMed Setting Facility Modifier None Typical Low $134.90 Median $2,137.96 Typical High $11,748.98 | Facility | None | $134.90 | $2,137.96 | $11,748.98 |
AvMed Setting Professional Modifier None Typical Low $87.10 Median $288.40 Typical High $380.19 | Professional | None | $87.10 | $288.40 | $380.19 |
Cigna Setting Facility Modifier None Typical Low $134.90 Median $269.15 Typical High $1,659.59 | Facility | None | $134.90 | $269.15 | $1,659.59 |
Cigna Setting Professional Modifier None Typical Low $63.10 Median $229.09 Typical High $346.74 | Professional | None | $63.10 | $229.09 | $346.74 |
Florida Blue Setting Facility Modifier None Typical Low $64.57 Median $131.83 Typical High $3,019.95 | Facility | None | $64.57 | $131.83 | $3,019.95 |
Florida Blue Setting Professional Modifier None Typical Low $151.36 Median $323.59 Typical High $416.87 | Professional | None | $151.36 | $323.59 | $416.87 |
Molina Setting Professional Modifier None Typical Low $70.79 Median $363.08 Typical High $812.83 | Professional | None | $70.79 | $363.08 | $812.83 |
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 $66.07 Median $213.80 Typical High $380.19 | Professional | None | $66.07 | $213.80 | $380.19 |
Wellpoint Setting Professional Modifier None Typical Low $64.57 Median $275.42 Typical High $275.42 | Professional | None | $64.57 | $275.42 | $275.42 |
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 $37.15 Median $131.83 Typical High $147.91 | Professional | 52 · Reduced service | $37.15 | $131.83 | $147.91 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $15.14 Median $52.48 Typical High $58.88 | Professional | 53 · Discontinued | $15.14 | $52.48 | $58.88 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $56.23 Median $194.98 Typical High $218.78 | Professional | 54 · Surgery only | $56.23 | $194.98 | $218.78 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $11.22 Median $38.90 Typical High $44.67 | Professional | 55 · Aftercare only | $11.22 | $38.90 | $44.67 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $7.41 Median $26.30 Typical High $29.51 | Professional | 56 · Pre-op care only | $7.41 | $26.30 | $29.51 |
Where Florida sits
The same service costs 4.8 times more in Wisconsin than in Washington, DC. 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· 42nd of 51
$234
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.