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 $56.23 Median $72.44 Typical High $107.15 | Professional | None | $56.23 | $72.44 | $107.15 |
Ambetter Setting Professional Modifier None Typical Low $87.10 Median $87.10 Typical High $87.10 | Professional | None | $87.10 | $87.10 | $87.10 |
AvMed Setting Facility Modifier None Typical Low $64.57 Median $2,137.96 Typical High $11,748.98 | Facility | None | $64.57 | $2,137.96 | $11,748.98 |
AvMed Setting Professional Modifier None Typical Low $63.10 Median $75.86 Typical High $97.72 | Professional | None | $63.10 | $75.86 | $97.72 |
Cigna Setting Facility Modifier None Typical Low $45.71 Median $93.33 Typical High $1,659.59 | Facility | None | $45.71 | $93.33 | $1,659.59 |
Cigna Setting Professional Modifier None Typical Low $47.86 Median $75.86 Typical High $151.36 | Professional | None | $47.86 | $75.86 | $151.36 |
Florida Blue Setting Facility Modifier None Typical Low $32.36 Median $70.79 Typical High $3,019.95 | Facility | None | $32.36 | $70.79 | $3,019.95 |
Florida Blue Setting Professional Modifier None Typical Low $63.10 Median $69.18 Typical High $162.18 | Professional | None | $63.10 | $69.18 | $162.18 |
Molina Setting Professional Modifier None Typical Low $52.48 Median $70.79 Typical High $141.25 | Professional | None | $52.48 | $70.79 | $141.25 |
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 $53.70 Median $85.11 Typical High $162.18 | Professional | None | $53.70 | $85.11 | $162.18 |
Wellpoint Setting Professional Modifier None Typical Low $43.65 Median $70.79 Typical High $70.79 | Professional | None | $43.65 | $70.79 | $70.79 |
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 $28.18 Median $36.31 Typical High $43.65 | Professional | 52 · Reduced service | $28.18 | $36.31 | $43.65 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $11.22 Median $14.45 Typical High $17.78 | Professional | 53 · Discontinued | $11.22 | $14.45 | $17.78 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $42.66 Median $54.95 Typical High $66.07 | Professional | 54 · Surgery only | $42.66 | $54.95 | $66.07 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $8.51 Median $10.96 Typical High $13.18 | Professional | 55 · Aftercare only | $8.51 | $10.96 | $13.18 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $5.62 Median $7.24 Typical High $8.71 | Professional | 56 · Pre-op care only | $5.62 | $7.24 | $8.71 |
Where Florida sits
The same service costs 3.5 times more in Wisconsin 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
$75.86
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.