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 $53.70 Median $95.50 Typical High $147.91 | Professional | None | $53.70 | $95.50 | $147.91 |
AvMed Setting Facility Modifier None Typical Low $144.54 Median $2,137.96 Typical High $11,748.98 | Facility | None | $144.54 | $2,137.96 | $11,748.98 |
AvMed Setting Professional Modifier None Typical Low $63.10 Median $138.04 Typical High $190.55 | Professional | None | $63.10 | $138.04 | $190.55 |
Cigna Setting Facility Modifier None Typical Low $144.54 Median $288.40 Typical High $2,691.53 | Facility | None | $144.54 | $288.40 | $2,691.53 |
Cigna Setting Professional Modifier None Typical Low $46.77 Median $117.49 Typical High $169.82 | Professional | None | $46.77 | $117.49 | $169.82 |
Florida Blue Setting Facility Modifier None Typical Low $64.57 Median $131.83 Typical High $5,370.32 | Facility | None | $64.57 | $131.83 | $5,370.32 |
Florida Blue Setting Professional Modifier None Typical Low $53.70 Median $134.90 Typical High $208.93 | Professional | None | $53.70 | $134.90 | $208.93 |
Molina Setting Professional Modifier None Typical Low $63.10 Median $138.04 Typical High $338.84 | Professional | None | $63.10 | $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 $50.12 Median $95.50 Typical High $165.96 | Professional | None | $50.12 | $95.50 | $165.96 |
Wellpoint Setting Professional Modifier None Typical Low $47.86 Median $138.04 Typical High $138.04 | Professional | None | $47.86 | $138.04 | $138.04 |
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 $26.92 Median $47.86 Typical High $60.26 | Professional | 52 · Reduced service | $26.92 | $47.86 | $60.26 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $10.72 Median $19.05 Typical High $23.99 | Professional | 53 · Discontinued | $10.72 | $19.05 | $23.99 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $40.74 Median $72.44 Typical High $89.13 | Professional | 54 · Surgery only | $40.74 | $72.44 | $89.13 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $8.13 Median $14.45 Typical High $17.78 | Professional | 55 · Aftercare only | $8.13 | $14.45 | $17.78 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $5.37 Median $9.55 Typical High $12.02 | Professional | 56 · Pre-op care only | $5.37 | $9.55 | $12.02 |
Where Florida sits
The same service costs 3.7 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· 49th of 51
$115
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.