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 $407.38 Median $3,090.30 Typical High $11,481.54 | Facility | None | $407.38 | $3,090.30 | $11,481.54 |
Aetna Setting Professional Modifier None Typical Low $123.03 Median $128.82 Typical High $169.82 | Professional | None | $123.03 | $128.82 | $169.82 |
AvMed Setting Facility Modifier None Typical Low $457.09 Median $1,445.44 Typical High $9,772.37 | Facility | None | $457.09 | $1,445.44 | $9,772.37 |
Cigna Setting Facility Modifier None Typical Low $331.13 Median $588.84 Typical High $1,659.59 | Facility | None | $331.13 | $588.84 | $1,659.59 |
Cigna Setting Professional Modifier None Typical Low $104.71 Median $151.36 Typical High $281.84 | Professional | None | $104.71 | $151.36 | $281.84 |
Florida Blue Setting Facility Modifier None Typical Low $123.03 Median $269.15 Typical High $4,466.84 | Facility | None | $123.03 | $269.15 | $4,466.84 |
Florida Blue Setting Professional Modifier None Typical Low $162.18 Median $288.40 Typical High $436.52 | Professional | None | $162.18 | $288.40 | $436.52 |
Molina Setting Professional Modifier None Typical Low $39.81 Median $39.81 Typical High $50.12 | Professional | None | $39.81 | $39.81 | $50.12 |
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 $60.26 Median $154.88 Typical High $302.00 | Professional | None | $60.26 | $154.88 | $302.00 |
Wellpoint Setting Professional Modifier None Typical Low $177.83 Median $177.83 Typical High $177.83 | Professional | None | $177.83 | $177.83 | $177.83 |
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 $61.66 Median $64.57 Typical High $77.62 | Professional | 52 · Reduced service | $61.66 | $64.57 | $77.62 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $24.55 Median $25.70 Typical High $30.90 | Professional | 53 · Discontinued | $24.55 | $25.70 | $30.90 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $91.20 Median $97.72 Typical High $114.82 | Professional | 54 · Surgery only | $91.20 | $97.72 | $114.82 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $18.20 Median $19.50 Typical High $23.44 | Professional | 55 · Aftercare only | $18.20 | $19.50 | $23.44 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $12.30 Median $12.88 Typical High $15.49 | Professional | 56 · Pre-op care only | $12.30 | $12.88 | $15.49 |
Where Florida sits
The same service costs 4.3 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· 19th of 51
$282
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.