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 $67.61 Median $100.00 Typical High $131.83 | Professional | None | $67.61 | $100.00 | $131.83 |
Ambetter Setting Professional Modifier None Typical Low $67.61 Median $67.61 Typical High $67.61 | Professional | None | $67.61 | $67.61 | $67.61 |
AvMed Setting Facility Modifier None Typical Low $2,818.38 Median $8,511.38 Typical High $13,182.57 | Facility | None | $2,818.38 | $8,511.38 | $13,182.57 |
AvMed Setting Professional Modifier None Typical Low $63.10 Median $69.18 Typical High $125.89 | Professional | None | $63.10 | $69.18 | $125.89 |
Cigna Setting Facility Modifier None Typical Low $109.65 Median $109.65 Typical High $323.59 | Facility | None | $109.65 | $109.65 | $323.59 |
Cigna Setting Professional Modifier None Typical Low $51.29 Median $83.18 Typical High $151.36 | Professional | None | $51.29 | $83.18 | $151.36 |
Florida Blue Setting Facility Modifier None Typical Low $1,348.96 Median $2,754.23 Typical High $6,309.57 | Facility | None | $1,348.96 | $2,754.23 | $6,309.57 |
Florida Blue Setting Professional Modifier None Typical Low $56.23 Median $93.33 Typical High $154.88 | Professional | None | $56.23 | $93.33 | $154.88 |
Molina Setting Professional Modifier None Typical Low $81.28 Median $114.82 Typical High $144.54 | Professional | None | $81.28 | $114.82 | $144.54 |
United Setting Facility Modifier None Typical Low $562.34 Median $4,897.79 Typical High $13,489.63 | Facility | None | $562.34 | $4,897.79 | $13,489.63 |
United Setting Professional Modifier None Typical Low $63.10 Median $102.33 Typical High $223.87 | Professional | None | $63.10 | $102.33 | $223.87 |
Wellpoint Setting Professional Modifier None Typical Low $61.66 Median $114.82 Typical High $114.82 | Professional | None | $61.66 | $114.82 | $114.82 |
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 $33.88 Median $50.12 Typical High $61.66 | Professional | 52 · Reduced service | $33.88 | $50.12 | $61.66 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $13.49 Median $19.95 Typical High $25.12 | Professional | 53 · Discontinued | $13.49 | $19.95 | $25.12 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $10.23 Median $15.14 Typical High $18.62 | Professional | 55 · Aftercare only | $10.23 | $15.14 | $18.62 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $6.76 Median $10.00 Typical High $12.30 | Professional | 56 · Pre-op care only | $6.76 | $10.00 | $12.30 |
Where Florida sits
The same service costs 8.7 times more in Oklahoma than in Michigan. 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· 41st of 51
$123
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.