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 $239.88 Median $3,801.89 Typical High $12,022.64 | Facility | None | $239.88 | $3,801.89 | $12,022.64 |
Aetna Setting Professional Modifier None Typical Low $173.78 Median $186.21 Typical High $229.09 | Professional | None | $173.78 | $186.21 | $229.09 |
Ambetter Setting Professional Modifier None Typical Low $131.83 Median $131.83 Typical High $239.88 | Professional | None | $131.83 | $131.83 | $239.88 |
AvMed Setting Facility Modifier None Typical Low $165.96 Median $2,137.96 Typical High $11,748.98 | Facility | None | $165.96 | $2,137.96 | $11,748.98 |
AvMed Setting Professional Modifier None Typical Low $165.96 Median $218.78 Typical High $263.03 | Professional | None | $165.96 | $218.78 | $263.03 |
Cigna Setting Facility Modifier None Typical Low $52.48 Median $186.21 Typical High $363.08 | Facility | None | $52.48 | $186.21 | $363.08 |
Cigna Setting Professional Modifier None Typical Low $151.36 Median $208.93 Typical High $398.11 | Professional | None | $151.36 | $208.93 | $398.11 |
Florida Blue Setting Facility Modifier None Typical Low $114.82 Median $251.19 Typical High $3,019.95 | Facility | None | $114.82 | $251.19 | $3,019.95 |
Florida Blue Setting Professional Modifier None Typical Low $138.04 Median $147.91 Typical High $239.88 | Professional | None | $138.04 | $147.91 | $239.88 |
Molina Setting Professional Modifier None Typical Low $138.04 Median $199.53 Typical High $363.08 | Professional | None | $138.04 | $199.53 | $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 $234.42 Typical High $436.52 | Professional | None | $60.26 | $234.42 | $436.52 |
Wellpoint Setting Professional Modifier None Typical Low $141.25 Median $141.25 Typical High $194.98 | Professional | None | $141.25 | $141.25 | $194.98 |
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 $87.10 Median $93.33 Typical High $109.65 | Professional | 52 · Reduced service | $87.10 | $93.33 | $109.65 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $34.67 Median $37.15 Typical High $43.65 | Professional | 53 · Discontinued | $34.67 | $37.15 | $43.65 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $131.83 Median $138.04 Typical High $162.18 | Professional | 54 · Surgery only | $131.83 | $138.04 | $162.18 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $26.30 Median $28.18 Typical High $33.11 | Professional | 55 · Aftercare only | $26.30 | $28.18 | $33.11 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $17.38 Median $18.62 Typical High $21.88 | Professional | 56 · Pre-op care only | $17.38 | $18.62 | $21.88 |
Where Florida sits
The same service costs 3.2 times more in Oklahoma 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· 47th of 51
$209
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.