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 $602.56 Median $3,890.45 Typical High $11,481.54 | Facility | None | $602.56 | $3,890.45 | $11,481.54 |
Aetna Setting Professional Modifier None Typical Low $275.42 Median $331.13 Typical High $549.54 | Professional | None | $275.42 | $331.13 | $549.54 |
Ambetter Setting Professional Modifier None Typical Low $263.03 Median $263.03 Typical High $263.03 | Professional | None | $263.03 | $263.03 | $263.03 |
AvMed Setting Facility Modifier None Typical Low $501.19 Median $2,137.96 Typical High $9,772.37 | Facility | None | $501.19 | $2,137.96 | $9,772.37 |
AvMed Setting Professional Modifier None Typical Low $239.88 Median $331.13 Typical High $436.52 | Professional | None | $239.88 | $331.13 | $436.52 |
Cigna Setting Facility Modifier None Typical Low $524.81 Median $2,691.53 Typical High $11,481.54 | Facility | None | $524.81 | $2,691.53 | $11,481.54 |
Cigna Setting Professional Modifier None Typical Low $229.09 Median $323.59 Typical High $645.65 | Professional | None | $229.09 | $323.59 | $645.65 |
Florida Blue Setting Facility Modifier None Typical Low $1,513.56 Median $3,162.28 Typical High $16,982.44 | Facility | None | $1,513.56 | $3,162.28 | $16,982.44 |
Florida Blue Setting Professional Modifier None Typical Low $204.17 Median $218.78 Typical High $426.58 | Professional | None | $204.17 | $218.78 | $426.58 |
Molina Setting Professional Modifier None Typical Low $251.19 Median $346.74 Typical High $645.65 | Professional | None | $251.19 | $346.74 | $645.65 |
United Setting Facility Modifier None Typical Low $954.99 Median $2,630.27 Typical High $10,000.00 | Facility | None | $954.99 | $2,630.27 | $10,000.00 |
United Setting Professional Modifier None Typical Low $60.26 Median $380.19 Typical High $758.58 | Professional | None | $60.26 | $380.19 | $758.58 |
Wellpoint Setting Professional Modifier None Typical Low $213.80 Median $213.80 Typical High $288.40 | Professional | None | $213.80 | $213.80 | $288.40 |
6 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 $131.83 Median $138.04 Typical High $177.83 | Professional | 52 · Reduced service | $131.83 | $138.04 | $177.83 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $53.70 Median $56.23 Typical High $70.79 | Professional | 53 · Discontinued | $53.70 | $56.23 | $70.79 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $199.53 Median $208.93 Typical High $263.03 | Professional | 54 · Surgery only | $199.53 | $208.93 | $263.03 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $39.81 Median $41.69 Typical High $52.48 | Professional | 55 · Aftercare only | $39.81 | $41.69 | $52.48 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $26.92 Median $28.18 Typical High $35.48 | Professional | 56 · Pre-op care only | $26.92 | $28.18 | $35.48 |
Ambetter Setting Professional Modifier 51 · Multiple procedures Typical Low $131.83 Median $131.83 Typical High $131.83 | Professional | 51 · Multiple procedures | $131.83 | $131.83 | $131.83 |
Where Florida sits
The same service costs 10.0 times more in Oklahoma 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· 9th of 51
$794
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.