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 $537.03 Median $3,311.31 Typical High $11,481.54 | Facility | None | $537.03 | $3,311.31 | $11,481.54 |
Aetna Setting Professional Modifier None Typical Low $478.63 Median $537.03 Typical High $707.95 | Professional | None | $478.63 | $537.03 | $707.95 |
AvMed Setting Facility Modifier None Typical Low $537.03 Median $2,691.53 Typical High $12,882.50 | Facility | None | $537.03 | $2,691.53 | $12,882.50 |
AvMed Setting Professional Modifier None Typical Low $398.11 Median $537.03 Typical High $758.58 | Professional | None | $398.11 | $537.03 | $758.58 |
Cigna Setting Facility Modifier None Typical Low $812.83 Median $2,754.23 Typical High $6,760.83 | Facility | None | $812.83 | $2,754.23 | $6,760.83 |
Cigna Setting Professional Modifier None Typical Low $436.52 Median $467.74 Typical High $954.99 | Professional | None | $436.52 | $467.74 | $954.99 |
Florida Blue Setting Facility Modifier None Typical Low $1,659.59 Median $2,754.23 Typical High $5,011.87 | Facility | None | $1,659.59 | $2,754.23 | $5,011.87 |
Florida Blue Setting Professional Modifier None Typical Low $138.04 Median $426.58 Typical High $630.96 | Professional | None | $138.04 | $426.58 | $630.96 |
Molina Setting Professional Modifier None Typical Low $134.90 Median $162.18 Typical High $223.87 | Professional | None | $134.90 | $162.18 | $223.87 |
United Setting Facility Modifier None Typical Low $1,000.00 Median $2,884.03 Typical High $10,715.19 | Facility | None | $1,000.00 | $2,884.03 | $10,715.19 |
United Setting Professional Modifier None Typical Low $208.93 Median $309.03 Typical High $630.96 | Professional | None | $208.93 | $309.03 | $630.96 |
Wellpoint Setting Professional Modifier None Typical Low $134.90 Median $134.90 Typical High $416.87 | Professional | None | $134.90 | $134.90 | $416.87 |
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 $239.88 Median $269.15 Typical High $338.84 | Professional | 52 · Reduced service | $239.88 | $269.15 | $338.84 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $97.72 Median $107.15 Typical High $138.04 | Professional | 53 · Discontinued | $97.72 | $107.15 | $138.04 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $363.08 Median $398.11 Typical High $512.86 | Professional | 54 · Surgery only | $363.08 | $398.11 | $512.86 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $72.44 Median $79.43 Typical High $102.33 | Professional | 55 · Aftercare only | $72.44 | $79.43 | $102.33 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $47.86 Median $53.70 Typical High $69.18 | Professional | 56 · Pre-op care only | $47.86 | $53.70 | $69.18 |
Where Florida sits
The same service costs 10.0 times more in Alaska than in Kentucky. 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· 43rd of 51
$537
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.