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 $407.38 Median $3,090.30 Typical High $11,481.54 | Facility | None | $407.38 | $3,090.30 | $11,481.54 |
Aetna Setting Professional Modifier None Typical Low $66.07 Median $66.07 Typical High $89.13 | Professional | None | $66.07 | $66.07 | $89.13 |
AvMed Setting Facility Modifier None Typical Low $331.13 Median $1,348.96 Typical High $9,549.93 | Facility | None | $331.13 | $1,348.96 | $9,549.93 |
AvMed Setting Professional Modifier None Typical Low $57.54 Median $75.86 Typical High $83.18 | Professional | None | $57.54 | $75.86 | $83.18 |
Cigna Setting Facility Modifier None Typical Low $323.59 Median $1,412.54 Typical High $2,344.23 | Facility | None | $323.59 | $1,412.54 | $2,344.23 |
Cigna Setting Professional Modifier None Typical Low $52.48 Median $75.86 Typical High $151.36 | Professional | None | $52.48 | $75.86 | $151.36 |
Florida Blue Setting Facility Modifier None Typical Low $660.69 Median $1,348.96 Typical High $11,748.98 | Facility | None | $660.69 | $1,348.96 | $11,748.98 |
Florida Blue Setting Professional Modifier None Typical Low $47.86 Median $51.29 Typical High $229.09 | Professional | None | $47.86 | $51.29 | $229.09 |
Molina Setting Professional Modifier None Typical Low $52.48 Median $72.44 Typical High $141.25 | Professional | None | $52.48 | $72.44 | $141.25 |
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 $54.95 Median $81.28 Typical High $154.88 | Professional | None | $54.95 | $81.28 | $154.88 |
Wellpoint Setting Professional Modifier None Typical Low $52.48 Median $52.48 Typical High $69.18 | Professional | None | $52.48 | $52.48 | $69.18 |
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 $32.36 Median $33.11 Typical High $43.65 | Professional | 52 · Reduced service | $32.36 | $33.11 | $43.65 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $13.18 Median $13.18 Typical High $17.38 | Professional | 53 · Discontinued | $13.18 | $13.18 | $17.38 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $48.98 Median $48.98 Typical High $66.07 | Professional | 54 · Surgery only | $48.98 | $48.98 | $66.07 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $9.77 Median $9.77 Typical High $13.18 | Professional | 55 · Aftercare only | $9.77 | $9.77 | $13.18 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $6.61 Median $6.61 Typical High $8.71 | Professional | 56 · Pre-op care only | $6.61 | $6.61 | $8.71 |
Where Florida sits
The same service costs 11.2 times more in Tennessee 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· 7th of 51
$398
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.