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 $2,951.21 Typical High $10,964.78 | Facility | None | $338.84 | $2,951.21 | $10,964.78 |
Aetna Setting Professional Modifier None Typical Low $31.62 Median $97.72 Typical High $138.04 | Professional | None | $31.62 | $97.72 | $138.04 |
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 $38.02 Median $131.83 Typical High $173.78 | Professional | None | $38.02 | $131.83 | $173.78 |
Cigna Setting Facility Modifier None Typical Low $50.12 Median $66.07 Typical High $724.44 | Facility | None | $50.12 | $66.07 | $724.44 |
Cigna Setting Professional Modifier None Typical Low $28.18 Median $109.65 Typical High $165.96 | Professional | None | $28.18 | $109.65 | $165.96 |
Florida Blue Setting Facility Modifier None Typical Low $64.57 Median $138.04 Typical High $4,570.88 | Facility | None | $64.57 | $138.04 | $4,570.88 |
Florida Blue Setting Professional Modifier None Typical Low $47.86 Median $87.10 Typical High $186.21 | Professional | None | $47.86 | $87.10 | $186.21 |
Molina Setting Professional Modifier None Typical Low $38.90 Median $138.04 Typical High $338.84 | Professional | None | $38.90 | $138.04 | $338.84 |
United Setting Facility Modifier None Typical Low $281.84 Median $660.69 Typical High $4,073.80 | Facility | None | $281.84 | $660.69 | $4,073.80 |
United Setting Professional Modifier None Typical Low $29.51 Median $81.28 Typical High $162.18 | Professional | None | $29.51 | $81.28 | $162.18 |
Wellpoint Setting Professional Modifier None Typical Low $29.51 Median $131.83 Typical High $131.83 | Professional | None | $29.51 | $131.83 | $131.83 |
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 $15.85 Median $48.98 Typical High $69.18 | Professional | 52 · Reduced service | $15.85 | $48.98 | $69.18 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $6.31 Median $19.50 Typical High $27.54 | Professional | 53 · Discontinued | $6.31 | $19.50 | $27.54 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $23.44 Median $74.13 Typical High $104.71 | Professional | 54 · Surgery only | $23.44 | $74.13 | $104.71 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $4.68 Median $14.79 Typical High $20.89 | Professional | 55 · Aftercare only | $4.68 | $14.79 | $20.89 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $3.16 Median $9.77 Typical High $13.80 | Professional | 56 · Pre-op care only | $3.16 | $9.77 | $13.80 |
Where Florida sits
The same service costs 4.6 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· 34th of 51
$112
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.