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 $100.00 Median $3,311.31 Typical High $12,022.64 | Facility | None | $100.00 | $3,311.31 | $12,022.64 |
Aetna Setting Professional Modifier None Typical Low $74.13 Median $100.00 Typical High $154.88 | Professional | None | $74.13 | $100.00 | $154.88 |
Ambetter Setting Professional Modifier None Typical Low $120.23 Median $120.23 Typical High $125.89 | Professional | None | $120.23 | $120.23 | $125.89 |
AvMed Setting Facility Modifier None Typical Low $87.10 Median $2,137.96 Typical High $11,748.98 | Facility | None | $87.10 | $2,137.96 | $11,748.98 |
AvMed Setting Professional Modifier None Typical Low $83.18 Median $104.71 Typical High $138.04 | Professional | None | $83.18 | $104.71 | $138.04 |
Cigna Setting Facility Modifier None Typical Low $52.48 Median $81.28 Typical High $162.18 | Facility | None | $52.48 | $81.28 | $162.18 |
Cigna Setting Professional Modifier None Typical Low $63.10 Median $100.00 Typical High $199.53 | Professional | None | $63.10 | $100.00 | $199.53 |
Florida Blue Setting Facility Modifier None Typical Low $60.26 Median $131.83 Typical High $4,466.84 | Facility | None | $60.26 | $131.83 | $4,466.84 |
Florida Blue Setting Professional Modifier None Typical Low $89.13 Median $95.50 Typical High $125.89 | Professional | None | $89.13 | $95.50 | $125.89 |
Molina Setting Professional Modifier None Typical Low $77.62 Median $107.15 Typical High $208.93 | Professional | None | $77.62 | $107.15 | $208.93 |
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 $67.61 Median $114.82 Typical High $223.87 | Professional | None | $67.61 | $114.82 | $223.87 |
Wellpoint Setting Professional Modifier None Typical Low $60.26 Median $97.72 Typical High $97.72 | Professional | None | $60.26 | $97.72 | $97.72 |
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 $37.15 Median $50.12 Typical High $61.66 | Professional | 52 · Reduced service | $37.15 | $50.12 | $61.66 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $14.79 Median $19.95 Typical High $24.55 | Professional | 53 · Discontinued | $14.79 | $19.95 | $24.55 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $54.95 Median $75.86 Typical High $93.33 | Professional | 54 · Surgery only | $54.95 | $75.86 | $93.33 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $10.96 Median $15.14 Typical High $18.62 | Professional | 55 · Aftercare only | $10.96 | $15.14 | $18.62 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $7.41 Median $10.00 Typical High $12.30 | Professional | 56 · Pre-op care only | $7.41 | $10.00 | $12.30 |
Where Florida sits
The same service costs 3.2 times more in Wisconsin than in Texas. 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· 48th of 51
$112
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.