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 $134.90 Median $2,884.03 Typical High $10,964.78 | Facility | None | $134.90 | $2,884.03 | $10,964.78 |
Aetna Setting Professional Modifier None Typical Low $56.23 Median $83.18 Typical High $117.49 | Professional | None | $56.23 | $83.18 | $117.49 |
Ambetter Setting Professional Modifier None Typical Low $74.13 Median $74.13 Typical High $74.13 | Professional | None | $74.13 | $74.13 | $74.13 |
AvMed Setting Facility Modifier None Typical Low $48.98 Median $630.96 Typical High $2,818.38 | Facility | None | $48.98 | $630.96 | $2,818.38 |
AvMed Setting Professional Modifier None Typical Low $51.29 Median $72.44 Typical High $100.00 | Professional | None | $51.29 | $72.44 | $100.00 |
Cigna Setting Facility Modifier None Typical Low $40.74 Median $81.28 Typical High $1,659.59 | Facility | None | $40.74 | $81.28 | $1,659.59 |
Cigna Setting Professional Modifier None Typical Low $38.90 Median $57.54 Typical High $120.23 | Professional | None | $38.90 | $57.54 | $120.23 |
Florida Blue Setting Facility Modifier None Typical Low $60.26 Median $134.90 Typical High $3,019.95 | Facility | None | $60.26 | $134.90 | $3,019.95 |
Florida Blue Setting Professional Modifier None Typical Low $44.67 Median $77.62 Typical High $134.90 | Professional | None | $44.67 | $77.62 | $134.90 |
Molina Setting Professional Modifier None Typical Low $39.81 Median $60.26 Typical High $97.72 | Professional | None | $39.81 | $60.26 | $97.72 |
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 $40.74 Median $60.26 Typical High $123.03 | Professional | None | $40.74 | $60.26 | $123.03 |
Wellpoint Setting Professional Modifier None Typical Low $36.31 Median $61.66 Typical High $61.66 | Professional | None | $36.31 | $61.66 | $61.66 |
6 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 $28.18 Median $37.15 Typical High $44.67 | Professional | 52 · Reduced service | $28.18 | $37.15 | $44.67 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $11.22 Median $14.79 Typical High $17.78 | Professional | 53 · Discontinued | $11.22 | $14.79 | $17.78 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $42.66 Median $56.23 Typical High $67.61 | Professional | 54 · Surgery only | $42.66 | $56.23 | $67.61 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $8.51 Median $11.22 Typical High $13.49 | Professional | 55 · Aftercare only | $8.51 | $11.22 | $13.49 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $5.62 Median $7.41 Typical High $8.91 | Professional | 56 · Pre-op care only | $5.62 | $7.41 | $8.91 |
Ambetter Setting Professional Modifier 50 · Both sides Typical Low $112.20 Median $117.49 Typical High $144.54 | Professional | 50 · Both sides | $112.20 | $117.49 | $144.54 |
Where Florida sits
The same service costs 3.2 times more in Alaska than in Texas. 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· 50th of 51
$67.61
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.