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 $58.88 Median $1,862.09 Typical High $10,715.19 | Facility | None | $58.88 | $1,862.09 | $10,715.19 |
Aetna Setting Professional Modifier None Typical Low $44.67 Median $63.10 Typical High $128.82 | Professional | None | $44.67 | $63.10 | $128.82 |
Ambetter Setting Professional Modifier None Typical Low $40.74 Median $85.11 Typical High $114.82 | Professional | None | $40.74 | $85.11 | $114.82 |
AvMed Setting Facility Modifier None Typical Low $72.44 Median $2,137.96 Typical High $12,882.50 | Facility | None | $72.44 | $2,137.96 | $12,882.50 |
AvMed Setting Professional Modifier None Typical Low $66.07 Median $69.18 Typical High $79.43 | Professional | None | $66.07 | $69.18 | $79.43 |
Cigna Setting Facility Modifier None Typical Low $50.12 Median $66.07 Typical High $724.44 | Facility | None | $50.12 | $66.07 | $724.44 |
Cigna Setting Professional Modifier None Typical Low $37.15 Median $79.43 Typical High $151.36 | Professional | None | $37.15 | $79.43 | $151.36 |
Florida Blue Setting Facility Modifier None Typical Low $501.19 Median $912.01 Typical High $2,089.30 | Facility | None | $501.19 | $912.01 | $2,089.30 |
Florida Blue Setting Professional Modifier None Typical Low $51.29 Median $75.86 Typical High $100.00 | Professional | None | $51.29 | $75.86 | $100.00 |
Molina Setting Professional Modifier None Typical Low $45.71 Median $91.20 Typical High $134.90 | Professional | None | $45.71 | $91.20 | $134.90 |
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 $44.67 Median $77.62 Typical High $154.88 | Professional | None | $44.67 | $77.62 | $154.88 |
Wellpoint Setting Professional Modifier None Typical Low $34.67 Median $81.28 Typical High $81.28 | Professional | None | $34.67 | $81.28 | $81.28 |
7 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 $21.38 Median $29.51 Typical High $42.66 | Professional | 52 · Reduced service | $21.38 | $29.51 | $42.66 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $8.71 Median $11.75 Typical High $16.98 | Professional | 53 · Discontinued | $8.71 | $11.75 | $16.98 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $32.36 Median $44.67 Typical High $64.57 | Professional | 54 · Surgery only | $32.36 | $44.67 | $64.57 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $6.46 Median $8.91 Typical High $12.88 | Professional | 55 · Aftercare only | $6.46 | $8.91 | $12.88 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $4.37 Median $5.89 Typical High $8.51 | Professional | 56 · Pre-op care only | $4.37 | $5.89 | $8.51 |
Ambetter Setting Professional Modifier 51 · Multiple procedures Typical Low $22.39 Median $41.69 Typical High $79.43 | Professional | 51 · Multiple procedures | $22.39 | $41.69 | $79.43 |
Ambetter Setting Professional Modifier 53 · Discontinued Typical Low $75.86 Median $95.50 Typical High $104.71 | Professional | 53 · Discontinued | $75.86 | $95.50 | $104.71 |
Where Florida sits
The same service costs 3.2 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· 43rd of 51
$93.33
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.