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 $61.66 Median $3,311.31 Typical High $12,022.64 | Facility | None | $61.66 | $3,311.31 | $12,022.64 |
Aetna Setting Professional Modifier None Typical Low $40.74 Median $61.66 Typical High $100.00 | Professional | None | $40.74 | $61.66 | $100.00 |
Ambetter Setting Professional Modifier None Typical Low $64.57 Median $64.57 Typical High $125.89 | Professional | None | $64.57 | $64.57 | $125.89 |
AvMed Setting Facility Modifier None Typical Low $47.86 Median $2,137.96 Typical High $11,748.98 | Facility | None | $47.86 | $2,137.96 | $11,748.98 |
AvMed Setting Professional Modifier None Typical Low $45.71 Median $60.26 Typical High $81.28 | Professional | None | $45.71 | $60.26 | $81.28 |
Cigna Setting Facility Modifier None Typical Low $35.48 Median $50.12 Typical High $79.43 | Facility | None | $35.48 | $50.12 | $79.43 |
Cigna Setting Professional Modifier None Typical Low $35.48 Median $60.26 Typical High $117.49 | Professional | None | $35.48 | $60.26 | $117.49 |
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 $50.12 Median $53.70 Typical High $79.43 | Professional | None | $50.12 | $53.70 | $79.43 |
Molina Setting Professional Modifier None Typical Low $51.29 Median $70.79 Typical High $141.25 | Professional | None | $51.29 | $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 $40.74 Median $67.61 Typical High $131.83 | Professional | None | $40.74 | $67.61 | $131.83 |
Wellpoint Setting Professional Modifier None Typical Low $31.62 Median $54.95 Typical High $54.95 | Professional | None | $31.62 | $54.95 | $54.95 |
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 $20.42 Median $29.51 Typical High $34.67 | Professional | 52 · Reduced service | $20.42 | $29.51 | $34.67 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $8.13 Median $11.75 Typical High $13.80 | Professional | 53 · Discontinued | $8.13 | $11.75 | $13.80 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $30.90 Median $44.67 Typical High $52.48 | Professional | 54 · Surgery only | $30.90 | $44.67 | $52.48 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $6.17 Median $8.91 Typical High $10.47 | Professional | 55 · Aftercare only | $6.17 | $8.91 | $10.47 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $4.07 Median $5.89 Typical High $6.92 | Professional | 56 · Pre-op care only | $4.07 | $5.89 | $6.92 |
Where Florida sits
The same service costs 3.1 times more in Wisconsin than in Washington, DC. 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· 49th of 51
$66.07
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.