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 $338.84 Median $3,090.30 Typical High $10,715.19 | Facility | None | $338.84 | $3,090.30 | $10,715.19 |
Aetna Setting Professional Modifier None Typical Low $95.50 Median $151.36 Typical High $208.93 | Professional | None | $95.50 | $151.36 | $208.93 |
AvMed Setting Facility Modifier None Typical Low $263.03 Median $1,230.27 Typical High $9,549.93 | Facility | None | $263.03 | $1,230.27 | $9,549.93 |
AvMed Setting Professional Modifier None Typical Low $107.15 Median $190.55 Typical High $251.19 | Professional | None | $107.15 | $190.55 | $251.19 |
Cigna Setting Facility Modifier None Typical Low $323.59 Median $776.25 Typical High $1,659.59 | Facility | None | $323.59 | $776.25 | $1,659.59 |
Cigna Setting Professional Modifier None Typical Low $79.43 Median $154.88 Typical High $234.42 | Professional | None | $79.43 | $154.88 | $234.42 |
Florida Blue Setting Facility Modifier None Typical Low $489.78 Median $1,071.52 Typical High $5,370.32 | Facility | None | $489.78 | $1,071.52 | $5,370.32 |
Florida Blue Setting Professional Modifier None Typical Low $95.50 Median $151.36 Typical High $275.42 | Professional | None | $95.50 | $151.36 | $275.42 |
Molina Setting Professional Modifier None Typical Low $107.15 Median $190.55 Typical High $478.63 | Professional | None | $107.15 | $190.55 | $478.63 |
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 $83.18 Median $141.25 Typical High $239.88 | Professional | None | $83.18 | $141.25 | $239.88 |
Wellpoint Setting Professional Modifier None Typical Low $79.43 Median $181.97 Typical High $181.97 | Professional | None | $79.43 | $181.97 | $181.97 |
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 $75.86 Typical High $95.50 | Professional | 52 · Reduced service | $47.86 | $75.86 | $95.50 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $19.05 Median $30.20 Typical High $38.02 | Professional | 53 · Discontinued | $19.05 | $30.20 | $38.02 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $72.44 Median $112.20 Typical High $141.25 | Professional | 54 · Surgery only | $72.44 | $112.20 | $141.25 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $14.45 Median $22.39 Typical High $28.18 | Professional | 55 · Aftercare only | $14.45 | $22.39 | $28.18 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $9.55 Median $15.14 Typical High $19.05 | Professional | 56 · Pre-op care only | $9.55 | $15.14 | $19.05 |
Where Florida sits
The same service costs 3.8 times more in Alaska 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· 47th of 51
$162
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.