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 $354.81 Median $3,019.95 Typical High $10,964.78 | Facility | None | $354.81 | $3,019.95 | $10,964.78 |
Aetna Setting Professional Modifier None Typical Low $134.90 Median $239.88 Typical High $363.08 | Professional | None | $134.90 | $239.88 | $363.08 |
AvMed Setting Facility Modifier None Typical Low $288.40 Median $6,025.60 Typical High $13,182.57 | Facility | None | $288.40 | $6,025.60 | $13,182.57 |
AvMed Setting Professional Modifier None Typical Low $141.25 Median $275.42 Typical High $354.81 | Professional | None | $141.25 | $275.42 | $354.81 |
Cigna Setting Facility Modifier None Typical Low $239.88 Median $239.88 Typical High $239.88 | Facility | None | $239.88 | $239.88 | $239.88 |
Cigna Setting Professional Modifier None Typical Low $107.15 Median $234.42 Typical High $524.81 | Professional | None | $107.15 | $234.42 | $524.81 |
Florida Blue Setting Facility Modifier None Typical Low $58.88 Median $323.59 Typical High $323.59 | Facility | None | $58.88 | $323.59 | $323.59 |
Florida Blue Setting Professional Modifier None Typical Low $234.42 Median $309.03 Typical High $436.52 | Professional | None | $234.42 | $309.03 | $436.52 |
Molina Setting Professional Modifier None Typical Low $173.78 Median $269.15 Typical High $676.08 | Professional | None | $173.78 | $269.15 | $676.08 |
United Setting Facility Modifier None Typical Low $169.82 Median $1,819.70 Typical High $5,248.07 | Facility | None | $169.82 | $1,819.70 | $5,248.07 |
United Setting Professional Modifier None Typical Low $131.83 Median $269.15 Typical High $537.03 | Professional | None | $131.83 | $269.15 | $537.03 |
Wellpoint Setting Professional Modifier None Typical Low $104.71 Median $181.97 Typical High $181.97 | Professional | None | $104.71 | $181.97 | $181.97 |
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 $67.61 Median $120.23 Typical High $173.78 | Professional | 52 · Reduced service | $67.61 | $120.23 | $173.78 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $26.92 Median $47.86 Typical High $69.18 | Professional | 53 · Discontinued | $26.92 | $47.86 | $69.18 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $100.00 Median $177.83 Typical High $263.03 | Professional | 54 · Surgery only | $100.00 | $177.83 | $263.03 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $19.95 Median $35.48 Typical High $52.48 | Professional | 55 · Aftercare only | $19.95 | $35.48 | $52.48 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $13.49 Median $23.99 Typical High $34.67 | Professional | 56 · Pre-op care only | $13.49 | $23.99 | $34.67 |
Where Florida sits
The same service costs 3.5 times more in Alaska than in Virginia. 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· 46th of 51
$257
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.