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 $79.43 Median $2,630.27 Typical High $10,715.19 | Facility | None | $79.43 | $2,630.27 | $10,715.19 |
Aetna Setting Professional Modifier None Typical Low $47.86 Median $81.28 Typical High $138.04 | Professional | None | $47.86 | $81.28 | $138.04 |
Ambetter Setting Professional Modifier None Typical Low $85.11 Median $95.50 Typical High $128.82 | Professional | None | $85.11 | $95.50 | $128.82 |
AvMed Setting Facility Modifier None Typical Low $67.61 Median $2,137.96 Typical High $11,748.98 | Facility | None | $67.61 | $2,137.96 | $11,748.98 |
AvMed Setting Professional Modifier None Typical Low $52.48 Median $85.11 Typical High $114.82 | Professional | None | $52.48 | $85.11 | $114.82 |
Cigna Setting Facility Modifier None Typical Low $67.61 Median $134.90 Typical High $1,659.59 | Facility | None | $67.61 | $134.90 | $1,659.59 |
Cigna Setting Professional Modifier None Typical Low $38.02 Median $72.44 Typical High $154.88 | Professional | None | $38.02 | $72.44 | $154.88 |
Florida Blue Setting Facility Modifier None Typical Low $60.26 Median $131.83 Typical High $3,019.95 | Facility | None | $60.26 | $131.83 | $3,019.95 |
Florida Blue Setting Professional Modifier None Typical Low $70.79 Median $75.86 Typical High $117.49 | Professional | None | $70.79 | $75.86 | $117.49 |
Molina Setting Professional Modifier None Typical Low $72.44 Median $107.15 Typical High $208.93 | Professional | None | $72.44 | $107.15 | $208.93 |
United Setting Facility Modifier None Typical Low $81.28 Median $302.00 Typical High $2,818.38 | Facility | None | $81.28 | $302.00 | $2,818.38 |
United Setting Professional Modifier None Typical Low $45.71 Median $87.10 Typical High $173.78 | Professional | None | $45.71 | $87.10 | $173.78 |
Wellpoint Setting Professional Modifier None Typical Low $36.31 Median $79.43 Typical High $79.43 | Professional | None | $36.31 | $79.43 | $79.43 |
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 $23.44 Median $37.15 Typical High $47.86 | Professional | 52 · Reduced service | $23.44 | $37.15 | $47.86 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $9.33 Median $14.79 Typical High $19.05 | Professional | 53 · Discontinued | $9.33 | $14.79 | $19.05 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $34.67 Median $56.23 Typical High $70.79 | Professional | 54 · Surgery only | $34.67 | $56.23 | $70.79 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $6.92 Median $11.22 Typical High $14.45 | Professional | 55 · Aftercare only | $6.92 | $11.22 | $14.45 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $4.68 Median $7.41 Typical High $9.55 | Professional | 56 · Pre-op care only | $4.68 | $7.41 | $9.55 |
Where Florida sits
The same service costs 2.8 times more in Wisconsin than in Kentucky. 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· 45th of 51
$95.50
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.