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 $218.78 Median $2,884.03 Typical High $10,964.78 | Facility | None | $218.78 | $2,884.03 | $10,964.78 |
Aetna Setting Professional Modifier None Typical Low $104.71 Median $134.90 Typical High $234.42 | Professional | None | $104.71 | $134.90 | $234.42 |
Ambetter Setting Professional Modifier None Typical Low $169.82 Median $173.78 Typical High $275.42 | Professional | None | $169.82 | $173.78 | $275.42 |
AvMed Setting Facility Modifier None Typical Low $131.83 Median $2,137.96 Typical High $11,748.98 | Facility | None | $131.83 | $2,137.96 | $11,748.98 |
AvMed Setting Professional Modifier None Typical Low $120.23 Median $154.88 Typical High $194.98 | Professional | None | $120.23 | $154.88 | $194.98 |
Cigna Setting Facility Modifier None Typical Low $95.50 Median $190.55 Typical High $1,659.59 | Facility | None | $95.50 | $190.55 | $1,659.59 |
Cigna Setting Professional Modifier None Typical Low $93.33 Median $147.91 Typical High $288.40 | Professional | None | $93.33 | $147.91 | $288.40 |
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 $114.82 Median $138.04 Typical High $173.78 | Professional | None | $114.82 | $138.04 | $173.78 |
Molina Setting Professional Modifier None Typical Low $128.82 Median $177.83 Typical High $346.74 | Professional | None | $128.82 | $177.83 | $346.74 |
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 $100.00 Median $165.96 Typical High $323.59 | Professional | None | $100.00 | $165.96 | $323.59 |
Wellpoint Setting Professional Modifier None Typical Low $85.11 Median $141.25 Typical High $141.25 | Professional | None | $85.11 | $141.25 | $141.25 |
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 $52.48 Median $64.57 Typical High $81.28 | Professional | 52 · Reduced service | $52.48 | $64.57 | $81.28 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $20.89 Median $25.70 Typical High $32.36 | Professional | 53 · Discontinued | $20.89 | $25.70 | $32.36 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $79.43 Median $97.72 Typical High $120.23 | Professional | 54 · Surgery only | $79.43 | $97.72 | $120.23 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $15.85 Median $19.50 Typical High $23.99 | Professional | 55 · Aftercare only | $15.85 | $19.50 | $23.99 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $10.47 Median $12.88 Typical High $16.22 | Professional | 56 · Pre-op care only | $10.47 | $12.88 | $16.22 |
Where Florida sits
The same service costs 3.7 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
$162
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.