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 $501.19 Median $3,715.35 Typical High $10,964.78 | Facility | None | $501.19 | $3,715.35 | $10,964.78 |
Aetna Setting Professional Modifier None Typical Low $173.78 Median $239.88 Typical High $389.05 | Professional | None | $173.78 | $239.88 | $389.05 |
Ambetter Setting Professional Modifier None Typical Low $181.97 Median $181.97 Typical High $181.97 | Professional | None | $181.97 | $181.97 | $181.97 |
AvMed Setting Facility Modifier None Typical Low $295.12 Median $1,348.96 Typical High $9,772.37 | Facility | None | $295.12 | $1,348.96 | $9,772.37 |
AvMed Setting Professional Modifier None Typical Low $190.55 Median $275.42 Typical High $354.81 | Professional | None | $190.55 | $275.42 | $354.81 |
Cigna Setting Facility Modifier None Typical Low $302.00 Median $436.52 Typical High $2,187.76 | Facility | None | $302.00 | $436.52 | $2,187.76 |
Cigna Setting Professional Modifier None Typical Low $144.54 Median $257.04 Typical High $537.03 | Professional | None | $144.54 | $257.04 | $537.03 |
Florida Blue Setting Facility Modifier None Typical Low $741.31 Median $1,621.81 Typical High $4,466.84 | Facility | None | $741.31 | $1,621.81 | $4,466.84 |
Florida Blue Setting Professional Modifier None Typical Low $208.93 Median $245.47 Typical High $363.08 | Professional | None | $208.93 | $245.47 | $363.08 |
Molina Setting Professional Modifier None Typical Low $251.19 Median $354.81 Typical High $707.95 | Professional | None | $251.19 | $354.81 | $707.95 |
United Setting Facility Modifier None Typical Low $398.11 Median $1,000.00 Typical High $5,623.41 | Facility | None | $398.11 | $1,000.00 | $5,623.41 |
United Setting Professional Modifier None Typical Low $154.88 Median $288.40 Typical High $549.54 | Professional | None | $154.88 | $288.40 | $549.54 |
Wellpoint Setting Professional Modifier None Typical Low $134.90 Median $251.19 Typical High $251.19 | Professional | None | $134.90 | $251.19 | $251.19 |
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 $85.11 Median $117.49 Typical High $162.18 | Professional | 52 · Reduced service | $85.11 | $117.49 | $162.18 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $34.67 Median $46.77 Typical High $64.57 | Professional | 53 · Discontinued | $34.67 | $46.77 | $64.57 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $128.82 Median $173.78 Typical High $245.47 | Professional | 54 · Surgery only | $128.82 | $173.78 | $245.47 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $25.70 Median $34.67 Typical High $48.98 | Professional | 55 · Aftercare only | $25.70 | $34.67 | $48.98 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $17.38 Median $23.44 Typical High $32.36 | Professional | 56 · Pre-op care only | $17.38 | $23.44 | $32.36 |
Where Florida sits
The same service costs 3.0 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· 26th of 51
$380
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.