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 $549.54 Median $3,801.89 Typical High $10,964.78 | Facility | None | $549.54 | $3,801.89 | $10,964.78 |
Aetna Setting Professional Modifier None Typical Low $194.98 Median $630.96 Typical High $912.01 | Professional | None | $194.98 | $630.96 | $912.01 |
AvMed Setting Facility Modifier None Typical Low $794.33 Median $5,128.61 Typical High $13,182.57 | Facility | None | $794.33 | $5,128.61 | $13,182.57 |
AvMed Setting Professional Modifier None Typical Low $194.98 Median $660.69 Typical High $870.96 | Professional | None | $194.98 | $660.69 | $870.96 |
Cigna Setting Facility Modifier None Typical Low $323.59 Median $323.59 Typical High $331.13 | Facility | None | $323.59 | $323.59 | $331.13 |
Cigna Setting Professional Modifier None Typical Low $154.88 Median $575.44 Typical High $1,230.27 | Professional | None | $154.88 | $575.44 | $1,230.27 |
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 $489.78 Median $741.31 Typical High $933.25 | Professional | None | $489.78 | $741.31 | $933.25 |
Molina Setting Professional Modifier None Typical Low $371.54 Median $645.65 Typical High $1,621.81 | Professional | None | $371.54 | $645.65 | $1,621.81 |
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 $186.21 Median $602.56 Typical High $1,318.26 | Professional | None | $186.21 | $602.56 | $1,318.26 |
Wellpoint Setting Professional Modifier None Typical Low $141.25 Median $630.96 Typical High $630.96 | Professional | None | $141.25 | $630.96 | $630.96 |
6 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 $95.50 Median $316.23 Typical High $446.68 | Professional | 52 · Reduced service | $95.50 | $316.23 | $446.68 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $38.90 Median $125.89 Typical High $177.83 | Professional | 53 · Discontinued | $38.90 | $125.89 | $177.83 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $144.54 Median $478.63 Typical High $676.08 | Professional | 54 · Surgery only | $144.54 | $478.63 | $676.08 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $28.84 Median $95.50 Typical High $134.90 | Professional | 55 · Aftercare only | $28.84 | $95.50 | $134.90 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $19.50 Median $63.10 Typical High $89.13 | Professional | 56 · Pre-op care only | $19.50 | $63.10 | $89.13 |
Ambetter Setting Professional Modifier 59 · Distinct service Typical Low $177.83 Median $177.83 Typical High $177.83 | Professional | 59 · Distinct service | $177.83 | $177.83 | $177.83 |
Where Florida sits
The same service costs 5.4 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· 43rd of 51
$631
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.