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 $354.81 Median $3,019.95 Typical High $10,964.78 | Facility | None | $354.81 | $3,019.95 | $10,964.78 |
Aetna Setting Professional Modifier None Typical Low $60.26 Median $83.18 Typical High $138.04 | Professional | None | $60.26 | $83.18 | $138.04 |
AvMed Setting Facility Modifier None Typical Low $100.00 Median $6,025.60 Typical High $13,182.57 | Facility | None | $100.00 | $6,025.60 | $13,182.57 |
AvMed Setting Professional Modifier None Typical Low $66.07 Median $97.72 Typical High $125.89 | Professional | None | $66.07 | $97.72 | $125.89 |
Cigna Setting Facility Modifier None Typical Low $109.65 Median $109.65 Typical High $109.65 | Facility | None | $109.65 | $109.65 | $109.65 |
Cigna Setting Professional Modifier None Typical Low $51.29 Median $87.10 Typical High $186.21 | Professional | None | $51.29 | $87.10 | $186.21 |
Florida Blue Setting Facility Modifier None Typical Low $104.71 Median $107.15 Typical High $181.97 | Facility | None | $104.71 | $107.15 | $181.97 |
Florida Blue Setting Professional Modifier None Typical Low $79.43 Median $128.82 Typical High $457.09 | Professional | None | $79.43 | $128.82 | $457.09 |
Molina Setting Professional Modifier None Typical Low $72.44 Median $81.28 Typical High $204.17 | Professional | None | $72.44 | $81.28 | $204.17 |
United Setting Facility Modifier None Typical Low $169.82 Median $1,819.70 Typical High $5,248.07 | Facility | None | $169.82 | $1,819.70 | $5,248.07 |
United Setting Professional Modifier None Typical Low $58.88 Median $95.50 Typical High $194.98 | Professional | None | $58.88 | $95.50 | $194.98 |
Wellpoint Setting Professional Modifier None Typical Low $48.98 Median $91.20 Typical High $91.20 | Professional | None | $48.98 | $91.20 | $91.20 |
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 $30.20 Median $41.69 Typical High $60.26 | Professional | 52 · Reduced service | $30.20 | $41.69 | $60.26 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $12.02 Median $16.60 Typical High $23.99 | Professional | 53 · Discontinued | $12.02 | $16.60 | $23.99 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $45.71 Median $61.66 Typical High $89.13 | Professional | 54 · Surgery only | $45.71 | $61.66 | $89.13 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $9.12 Median $12.30 Typical High $17.78 | Professional | 55 · Aftercare only | $9.12 | $12.30 | $17.78 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $6.03 Median $8.32 Typical High $12.02 | Professional | 56 · Pre-op care only | $6.03 | $8.32 | $12.02 |
Ambetter Setting Professional Modifier GC · Resident with teaching physician Typical Low $63.10 Median $63.10 Typical High $63.10 | Professional | GC · Resident with teaching physician | $63.10 | $63.10 | $63.10 |
Where Florida sits
The same service costs 3.2 times more in Alaska than in Florida. 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· 51st of 51
$87.10
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.