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 $107.15 Median $199.53 Typical High $288.40 | Professional | None | $107.15 | $199.53 | $288.40 |
AvMed Setting Facility Modifier None Typical Low $245.47 Median $4,897.79 Typical High $13,182.57 | Facility | None | $245.47 | $4,897.79 | $13,182.57 |
AvMed Setting Professional Modifier None Typical Low $107.15 Median $204.17 Typical High $275.42 | Professional | None | $107.15 | $204.17 | $275.42 |
Cigna Setting Facility Modifier None Typical Low $181.97 Median $181.97 Typical High $323.59 | Facility | None | $181.97 | $181.97 | $323.59 |
Cigna Setting Professional Modifier None Typical Low $87.10 Median $190.55 Typical High $416.87 | Professional | None | $87.10 | $190.55 | $416.87 |
Florida Blue Setting Facility Modifier None Typical Low $2,238.72 Median $3,311.31 Typical High $6,606.93 | Facility | None | $2,238.72 | $3,311.31 | $6,606.93 |
Florida Blue Setting Professional Modifier None Typical Low $169.82 Median $269.15 Typical High $331.13 | Professional | None | $169.82 | $269.15 | $331.13 |
Molina Setting Professional Modifier None Typical Low $151.36 Median $190.55 Typical High $467.74 | Professional | None | $151.36 | $190.55 | $467.74 |
United Setting Facility Modifier None Typical Low $398.11 Median $2,570.40 Typical High $5,011.87 | Facility | None | $398.11 | $2,570.40 | $5,011.87 |
United Setting Professional Modifier None Typical Low $109.65 Median $218.78 Typical High $426.58 | Professional | None | $109.65 | $218.78 | $426.58 |
Wellpoint Setting Professional Modifier None Typical Low $81.28 Median $194.98 Typical High $194.98 | Professional | None | $81.28 | $194.98 | $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 $53.70 Median $100.00 Typical High $141.25 | Professional | 52 · Reduced service | $53.70 | $100.00 | $141.25 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $21.38 Median $39.81 Typical High $56.23 | Professional | 53 · Discontinued | $21.38 | $39.81 | $56.23 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $81.28 Median $147.91 Typical High $208.93 | Professional | 54 · Surgery only | $81.28 | $147.91 | $208.93 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $16.22 Median $30.20 Typical High $42.66 | Professional | 55 · Aftercare only | $16.22 | $30.20 | $42.66 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $10.72 Median $19.95 Typical High $28.18 | Professional | 56 · Pre-op care only | $10.72 | $19.95 | $28.18 |
Where Florida sits
The same service costs 3.4 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
$195
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.