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 $398.11 Median $3,019.95 Typical High $11,481.54 | Facility | None | $398.11 | $3,019.95 | $11,481.54 |
Aetna Setting Professional Modifier None Typical Low $154.88 Median $165.96 Typical High $218.78 | Professional | None | $154.88 | $165.96 | $218.78 |
Ambetter Setting Professional Modifier None Typical Low $107.15 Median $107.15 Typical High $107.15 | Professional | None | $107.15 | $107.15 | $107.15 |
AvMed Setting Facility Modifier None Typical Low $158.49 Median $2,137.96 Typical High $11,748.98 | Facility | None | $158.49 | $2,137.96 | $11,748.98 |
AvMed Setting Professional Modifier None Typical Low $147.91 Median $194.98 Typical High $234.42 | Professional | None | $147.91 | $194.98 | $234.42 |
Cigna Setting Facility Modifier None Typical Low $154.88 Median $199.53 Typical High $363.08 | Facility | None | $154.88 | $199.53 | $363.08 |
Cigna Setting Professional Modifier None Typical Low $134.90 Median $186.21 Typical High $354.81 | Professional | None | $134.90 | $186.21 | $354.81 |
Florida Blue Setting Facility Modifier None Typical Low $281.84 Median $602.56 Typical High $3,019.95 | Facility | None | $281.84 | $602.56 | $3,019.95 |
Florida Blue Setting Professional Modifier None Typical Low $123.03 Median $131.83 Typical High $199.53 | Professional | None | $123.03 | $131.83 | $199.53 |
Molina Setting Professional Modifier None Typical Low $138.04 Median $194.98 Typical High $363.08 | Professional | None | $138.04 | $194.98 | $363.08 |
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 $60.26 Median $204.17 Typical High $389.05 | Professional | None | $60.26 | $204.17 | $389.05 |
Wellpoint Setting Professional Modifier None Typical Low $123.03 Median $123.03 Typical High $173.78 | Professional | None | $123.03 | $123.03 | $173.78 |
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 $77.62 Median $83.18 Typical High $97.72 | Professional | 52 · Reduced service | $77.62 | $83.18 | $97.72 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $30.90 Median $33.11 Typical High $38.90 | Professional | 53 · Discontinued | $30.90 | $33.11 | $38.90 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $117.49 Median $123.03 Typical High $144.54 | Professional | 54 · Surgery only | $117.49 | $123.03 | $144.54 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $23.44 Median $24.55 Typical High $28.84 | Professional | 55 · Aftercare only | $23.44 | $24.55 | $28.84 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $15.49 Median $16.60 Typical High $19.50 | Professional | 56 · Pre-op care only | $15.49 | $16.60 | $19.50 |
Where Florida sits
The same service costs 3.2 times more in Alaska than in Texas. 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· 28th of 51
$245
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.