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 $77.62 Median $2,884.03 Typical High $10,964.78 | Facility | None | $77.62 | $2,884.03 | $10,964.78 |
Aetna Setting Professional Modifier None Typical Low $56.23 Median $75.86 Typical High $125.89 | Professional | None | $56.23 | $75.86 | $125.89 |
Ambetter Setting Professional Modifier None Typical Low $56.23 Median $97.72 Typical High $107.15 | Professional | None | $56.23 | $97.72 | $107.15 |
AvMed Setting Facility Modifier None Typical Low $70.79 Median $2,137.96 Typical High $11,748.98 | Facility | None | $70.79 | $2,137.96 | $11,748.98 |
AvMed Setting Professional Modifier None Typical Low $64.57 Median $89.13 Typical High $112.20 | Professional | None | $64.57 | $89.13 | $112.20 |
Cigna Setting Facility Modifier None Typical Low $57.54 Median $117.49 Typical High $1,659.59 | Facility | None | $57.54 | $117.49 | $1,659.59 |
Cigna Setting Professional Modifier None Typical Low $50.12 Median $83.18 Typical High $162.18 | Professional | None | $50.12 | $83.18 | $162.18 |
Florida Blue Setting Facility Modifier None Typical Low $34.67 Median $70.79 Typical High $4,466.84 | Facility | None | $34.67 | $70.79 | $4,466.84 |
Florida Blue Setting Professional Modifier None Typical Low $64.57 Median $79.43 Typical High $100.00 | Professional | None | $64.57 | $79.43 | $100.00 |
Molina Setting Professional Modifier None Typical Low $75.86 Median $107.15 Typical High $208.93 | Professional | None | $75.86 | $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 $54.95 Median $91.20 Typical High $177.83 | Professional | None | $54.95 | $91.20 | $177.83 |
Wellpoint Setting Professional Modifier None Typical Low $45.71 Median $81.28 Typical High $81.28 | Professional | None | $45.71 | $81.28 | $81.28 |
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 $46.77 | Professional | 52 · Reduced service | $28.18 | $36.31 | $46.77 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $11.22 Median $14.45 Typical High $18.62 | Professional | 53 · Discontinued | $11.22 | $14.45 | $18.62 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $41.69 Median $53.70 Typical High $69.18 | Professional | 54 · Surgery only | $41.69 | $53.70 | $69.18 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $8.32 Median $10.96 Typical High $13.80 | Professional | 55 · Aftercare only | $8.32 | $10.96 | $13.80 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $5.62 Median $7.24 Typical High $9.33 | Professional | 56 · Pre-op care only | $5.62 | $7.24 | $9.33 |
Where Florida sits
The same service costs 3.6 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· 50th of 51
$91.20
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.