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 $275.42 Median $2,951.21 Typical High $10,964.78 | Facility | None | $275.42 | $2,951.21 | $10,964.78 |
Aetna Setting Professional Modifier None Typical Low $66.07 Median $251.19 Typical High $467.74 | Professional | None | $66.07 | $251.19 | $467.74 |
Ambetter Setting Professional Modifier None Typical Low $41.69 Median $57.54 Typical High $57.54 | Professional | None | $41.69 | $57.54 | $57.54 |
AvMed Setting Facility Modifier None Typical Low $389.05 Median $5,128.61 Typical High $13,182.57 | Facility | None | $389.05 | $5,128.61 | $13,182.57 |
AvMed Setting Professional Modifier None Typical Low $66.07 Median $323.59 Typical High $416.87 | Professional | None | $66.07 | $323.59 | $416.87 |
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 $281.84 Typical High $588.84 | Professional | None | $51.29 | $281.84 | $588.84 |
Florida Blue Setting Facility Modifier None Typical Low $6,456.54 Median $13,489.63 Typical High $23,442.29 | Facility | None | $6,456.54 | $13,489.63 | $23,442.29 |
Florida Blue Setting Professional Modifier None Typical Low $218.78 Median $346.74 Typical High $436.52 | Professional | None | $218.78 | $346.74 | $436.52 |
Molina Setting Professional Modifier None Typical Low $114.82 Median $323.59 Typical High $794.33 | Professional | None | $114.82 | $323.59 | $794.33 |
United Setting Facility Modifier None Typical Low $1,659.59 Median $8,128.31 Typical High $13,182.57 | Facility | None | $1,659.59 | $8,128.31 | $13,182.57 |
United Setting Professional Modifier None Typical Low $66.07 Median $263.03 Typical High $602.56 | Professional | None | $66.07 | $263.03 | $602.56 |
Wellpoint Setting Professional Modifier None Typical Low $47.86 Median $309.03 Typical High $309.03 | Professional | None | $47.86 | $309.03 | $309.03 |
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 $33.11 Median $125.89 Typical High $213.80 | Professional | 52 · Reduced service | $33.11 | $125.89 | $213.80 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $13.18 Median $50.12 Typical High $85.11 | Professional | 53 · Discontinued | $13.18 | $50.12 | $85.11 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $48.98 Median $186.21 Typical High $316.23 | Professional | 54 · Surgery only | $48.98 | $186.21 | $316.23 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $10.00 Median $37.15 Typical High $63.10 | Professional | 55 · Aftercare only | $10.00 | $37.15 | $63.10 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $6.61 Median $25.12 Typical High $42.66 | Professional | 56 · Pre-op care only | $6.61 | $25.12 | $42.66 |
Where Florida sits
The same service costs 5.6 times more in Wisconsin than in Maryland. 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· 39th of 51
$309
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.