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 $316.23 Median $331.13 Typical High $426.58 | Professional | None | $316.23 | $331.13 | $426.58 |
AvMed Setting Facility Modifier None Typical Low $331.13 Median $1,513.56 Typical High $9,772.37 | Facility | None | $331.13 | $1,513.56 | $9,772.37 |
AvMed Setting Professional Modifier None Typical Low $269.15 Median $363.08 Typical High $407.38 | Professional | None | $269.15 | $363.08 | $407.38 |
Cigna Setting Facility Modifier None Typical Low $323.59 Median $1,659.59 Typical High $3,019.95 | Facility | None | $323.59 | $1,659.59 | $3,019.95 |
Cigna Setting Professional Modifier None Typical Low $251.19 Median $363.08 Typical High $691.83 | Professional | None | $251.19 | $363.08 | $691.83 |
Florida Blue Setting Facility Modifier None Typical Low $302.00 Median $645.65 Typical High $16,982.44 | Facility | None | $302.00 | $645.65 | $16,982.44 |
Florida Blue Setting Professional Modifier None Typical Low $229.09 Median $245.47 Typical High $389.05 | Professional | None | $229.09 | $245.47 | $389.05 |
Molina Setting Professional Modifier None Typical Low $275.42 Median $380.19 Typical High $707.95 | Professional | None | $275.42 | $380.19 | $707.95 |
United Setting Facility Modifier None Typical Low $281.84 Median $660.69 Typical High $4,073.80 | Facility | None | $281.84 | $660.69 | $4,073.80 |
United Setting Professional Modifier None Typical Low $60.26 Median $398.11 Typical High $758.58 | Professional | None | $60.26 | $398.11 | $758.58 |
Wellpoint Setting Professional Modifier None Typical Low $245.47 Median $245.47 Typical High $323.59 | Professional | None | $245.47 | $245.47 | $323.59 |
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 $158.49 Median $165.96 Typical High $208.93 | Professional | 52 · Reduced service | $158.49 | $165.96 | $208.93 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $63.10 Median $66.07 Typical High $83.18 | Professional | 53 · Discontinued | $63.10 | $66.07 | $83.18 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $239.88 Median $251.19 Typical High $309.03 | Professional | 54 · Surgery only | $239.88 | $251.19 | $309.03 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $47.86 Median $50.12 Typical High $63.10 | Professional | 55 · Aftercare only | $47.86 | $50.12 | $63.10 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $31.62 Median $33.11 Typical High $41.69 | Professional | 56 · Pre-op care only | $31.62 | $33.11 | $41.69 |
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· 39th of 51
$447
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.