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 $645.65 Median $4,786.30 Typical High $12,022.64 | Facility | None | $645.65 | $4,786.30 | $12,022.64 |
Aetna Setting Professional Modifier None Typical Low $426.58 Median $457.09 Typical High $588.84 | Professional | None | $426.58 | $457.09 | $588.84 |
Ambetter Setting Professional Modifier None Typical Low $630.96 Median $630.96 Typical High $630.96 | Professional | None | $630.96 | $630.96 | $630.96 |
AvMed Setting Facility Modifier None Typical Low $457.09 Median $2,137.96 Typical High $11,748.98 | Facility | None | $457.09 | $2,137.96 | $11,748.98 |
AvMed Setting Professional Modifier None Typical Low $398.11 Median $524.81 Typical High $630.96 | Professional | None | $398.11 | $524.81 | $630.96 |
Cigna Setting Facility Modifier None Typical Low $457.09 Median $2,137.96 Typical High $2,754.23 | Facility | None | $457.09 | $2,137.96 | $2,754.23 |
Cigna Setting Professional Modifier None Typical Low $363.08 Median $501.19 Typical High $954.99 | Professional | None | $363.08 | $501.19 | $954.99 |
Florida Blue Setting Facility Modifier None Typical Low $10,471.29 Median $22,387.21 Typical High $33,884.42 | Facility | None | $10,471.29 | $22,387.21 | $33,884.42 |
Florida Blue Setting Professional Modifier None Typical Low $331.13 Median $354.81 Typical High $549.54 | Professional | None | $331.13 | $354.81 | $549.54 |
Molina Setting Professional Modifier None Typical Low $354.81 Median $512.86 Typical High $933.25 | Professional | None | $354.81 | $512.86 | $933.25 |
United Setting Facility Modifier None Typical Low $371.54 Median $954.99 Typical High $7,585.78 | Facility | None | $371.54 | $954.99 | $7,585.78 |
United Setting Professional Modifier None Typical Low $60.26 Median $562.34 Typical High $1,047.13 | Professional | None | $60.26 | $562.34 | $1,047.13 |
Wellpoint Setting Professional Modifier None Typical Low $331.13 Median $331.13 Typical High $467.74 | Professional | None | $331.13 | $331.13 | $467.74 |
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 $208.93 Median $223.87 Typical High $263.03 | Professional | 52 · Reduced service | $208.93 | $223.87 | $263.03 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $85.11 Median $89.13 Typical High $107.15 | Professional | 53 · Discontinued | $85.11 | $89.13 | $107.15 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $316.23 Median $338.84 Typical High $398.11 | Professional | 54 · Surgery only | $316.23 | $338.84 | $398.11 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $63.10 Median $67.61 Typical High $79.43 | Professional | 55 · Aftercare only | $63.10 | $67.61 | $79.43 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $41.69 Median $44.67 Typical High $53.70 | Professional | 56 · Pre-op care only | $41.69 | $44.67 | $53.70 |
Where Florida sits
The same service costs 3.4 times more in Alaska than in Utah. 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· 36th of 51
$562
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.