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 $436.52 Median $3,019.95 Typical High $10,964.78 | Facility | None | $436.52 | $3,019.95 | $10,964.78 |
Aetna Setting Professional Modifier None Typical Low $239.88 Median $316.23 Typical High $489.78 | Professional | None | $239.88 | $316.23 | $489.78 |
Ambetter Setting Professional Modifier None Typical Low $316.23 Median $363.08 Typical High $691.83 | Professional | None | $316.23 | $363.08 | $691.83 |
AvMed Setting Facility Modifier None Typical Low $407.38 Median $1,995.26 Typical High $9,549.93 | Facility | None | $407.38 | $1,995.26 | $9,549.93 |
AvMed Setting Professional Modifier None Typical Low $251.19 Median $346.74 Typical High $436.52 | Professional | None | $251.19 | $346.74 | $436.52 |
Cigna Setting Facility Modifier None Typical Low $436.52 Median $2,187.76 Typical High $4,073.80 | Facility | None | $436.52 | $2,187.76 | $4,073.80 |
Cigna Setting Professional Modifier None Typical Low $208.93 Median $338.84 Typical High $630.96 | Professional | None | $208.93 | $338.84 | $630.96 |
Florida Blue Setting Facility Modifier None Typical Low $302.00 Median $645.65 Typical High $16,982.44 | Facility | None | $302.00 | $645.65 | $16,982.44 |
Florida Blue Setting Professional Modifier None Typical Low $275.42 Median $316.23 Typical High $457.09 | Professional | None | $275.42 | $316.23 | $457.09 |
Molina Setting Professional Modifier None Typical Low $269.15 Median $331.13 Typical High $691.83 | Professional | None | $269.15 | $331.13 | $691.83 |
United Setting Facility Modifier None Typical Low $281.84 Median $645.65 Typical High $6,760.83 | Facility | None | $281.84 | $645.65 | $6,760.83 |
United Setting Professional Modifier None Typical Low $239.88 Median $389.05 Typical High $741.31 | Professional | None | $239.88 | $389.05 | $741.31 |
Wellpoint Setting Professional Modifier None Typical Low $199.53 Median $309.03 Typical High $309.03 | Professional | None | $199.53 | $309.03 | $309.03 |
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 $120.23 Median $154.88 Typical High $199.53 | Professional | 52 · Reduced service | $120.23 | $154.88 | $199.53 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $47.86 Median $61.66 Typical High $79.43 | Professional | 53 · Discontinued | $47.86 | $61.66 | $79.43 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $181.97 Median $234.42 Typical High $295.12 | Professional | 54 · Surgery only | $181.97 | $234.42 | $295.12 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $36.31 Median $46.77 Typical High $58.88 | Professional | 55 · Aftercare only | $36.31 | $46.77 | $58.88 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $23.99 Median $30.90 Typical High $39.81 | Professional | 56 · Pre-op care only | $23.99 | $30.90 | $39.81 |
Where Florida sits
The same service costs 3.9 times more in Alaska 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· 46th 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.