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 $602.56 Median $3,235.94 Typical High $10,964.78 | Facility | None | $602.56 | $3,235.94 | $10,964.78 |
Aetna Setting Professional Modifier None Typical Low $501.19 Median $524.81 Typical High $676.08 | Professional | None | $501.19 | $524.81 | $676.08 |
AvMed Setting Facility Modifier None Typical Low $446.68 Median $4,265.80 Typical High $11,748.98 | Facility | None | $446.68 | $4,265.80 | $11,748.98 |
AvMed Setting Professional Modifier None Typical Low $426.58 Median $562.34 Typical High $645.65 | Professional | None | $426.58 | $562.34 | $645.65 |
Cigna Setting Facility Modifier None Typical Low $457.09 Median $4,677.35 Typical High $8,912.51 | Facility | None | $457.09 | $4,677.35 | $8,912.51 |
Cigna Setting Professional Modifier None Typical Low $398.11 Median $562.34 Typical High $1,096.48 | Professional | None | $398.11 | $562.34 | $1,096.48 |
Florida Blue Setting Facility Modifier None Typical Low $794.33 Median $1,698.24 Typical High $16,982.44 | Facility | None | $794.33 | $1,698.24 | $16,982.44 |
Florida Blue Setting Professional Modifier None Typical Low $354.81 Median $380.19 Typical High $660.69 | Professional | None | $354.81 | $380.19 | $660.69 |
Molina Setting Professional Modifier None Typical Low $407.38 Median $562.34 Typical High $1,071.52 | Professional | None | $407.38 | $562.34 | $1,071.52 |
United Setting Facility Modifier None Typical Low $398.11 Median $1,000.00 Typical High $5,754.40 | Facility | None | $398.11 | $1,000.00 | $5,754.40 |
United Setting Professional Modifier None Typical Low $60.26 Median $630.96 Typical High $1,202.26 | Professional | None | $60.26 | $630.96 | $1,202.26 |
Wellpoint Setting Professional Modifier None Typical Low $380.19 Median $380.19 Typical High $512.86 | Professional | None | $380.19 | $380.19 | $512.86 |
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 $251.19 Median $263.03 Typical High $331.13 | Professional | 52 · Reduced service | $251.19 | $263.03 | $331.13 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $100.00 Median $104.71 Typical High $131.83 | Professional | 53 · Discontinued | $100.00 | $104.71 | $131.83 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $371.54 Median $398.11 Typical High $489.78 | Professional | 54 · Surgery only | $371.54 | $398.11 | $489.78 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $75.86 Median $79.43 Typical High $97.72 | Professional | 55 · Aftercare only | $75.86 | $79.43 | $97.72 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $50.12 Median $52.48 Typical High $66.07 | Professional | 56 · Pre-op care only | $50.12 | $52.48 | $66.07 |
Where Florida sits
The same service costs 3.9 times more in Alaska than in New York. 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· 32nd of 51
$794
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.