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 $3,890.45 Typical High $11,481.54 | Facility | None | $645.65 | $3,890.45 | $11,481.54 |
Aetna Setting Professional Modifier None Typical Low $436.52 Median $501.19 Typical High $1,202.26 | Professional | None | $436.52 | $501.19 | $1,202.26 |
Ambetter Setting Professional Modifier None Typical Low $275.42 Median $275.42 Typical High $275.42 | Professional | None | $275.42 | $275.42 | $275.42 |
AvMed Setting Facility Modifier None Typical Low $512.86 Median $4,265.80 Typical High $12,882.50 | Facility | None | $512.86 | $4,265.80 | $12,882.50 |
Cigna Setting Facility Modifier None Typical Low $398.11 Median $501.19 Typical High $2,691.53 | Facility | None | $398.11 | $501.19 | $2,691.53 |
Cigna Setting Professional Modifier None Typical Low $371.54 Median $478.63 Typical High $977.24 | Professional | None | $371.54 | $478.63 | $977.24 |
Florida Blue Setting Facility Modifier None Typical Low $1,380.38 Median $2,398.83 Typical High $4,265.80 | Facility | None | $1,380.38 | $2,398.83 | $4,265.80 |
Florida Blue Setting Professional Modifier None Typical Low $398.11 Median $416.87 Typical High $575.44 | Professional | None | $398.11 | $416.87 | $575.44 |
Molina Setting Professional Modifier None Typical Low $95.50 Median $114.82 Typical High $141.25 | Professional | None | $95.50 | $114.82 | $141.25 |
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 $34.67 Median $39.81 Typical High $60.26 | Professional | None | $34.67 | $39.81 | $60.26 |
Wellpoint Setting Professional Modifier None Typical Low $87.10 Median $87.10 Typical High $87.10 | Professional | None | $87.10 | $87.10 | $87.10 |
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 $218.78 Median $245.47 Typical High $295.12 | Professional | 52 · Reduced service | $218.78 | $245.47 | $295.12 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $87.10 Median $97.72 Typical High $117.49 | Professional | 53 · Discontinued | $87.10 | $97.72 | $117.49 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $323.59 Median $363.08 Typical High $436.52 | Professional | 54 · Surgery only | $323.59 | $363.08 | $436.52 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $64.57 Median $72.44 Typical High $87.10 | Professional | 55 · Aftercare only | $64.57 | $72.44 | $87.10 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $43.65 Median $48.98 Typical High $58.88 | Professional | 56 · Pre-op care only | $43.65 | $48.98 | $58.88 |
Where Florida sits
The same service costs 134.9 times more in Oklahoma than in Hawaii. 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· 32nd of 51
$575
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.