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 $338.84 Median $2,951.21 Typical High $10,964.78 | Facility | None | $338.84 | $2,951.21 | $10,964.78 |
Aetna Setting Professional Modifier None Typical Low $104.71 Median $131.83 Typical High $177.83 | Professional | None | $104.71 | $131.83 | $177.83 |
Ambetter Setting Professional Modifier None Typical Low $81.28 Median $81.28 Typical High $81.28 | Professional | None | $81.28 | $81.28 | $81.28 |
AvMed Setting Facility Modifier None Typical Low $128.82 Median $2,137.96 Typical High $11,748.98 | Facility | None | $128.82 | $2,137.96 | $11,748.98 |
AvMed Setting Professional Modifier None Typical Low $109.65 Median $147.91 Typical High $190.55 | Professional | None | $109.65 | $147.91 | $190.55 |
Cigna Setting Facility Modifier None Typical Low $66.07 Median $112.20 Typical High $549.54 | Facility | None | $66.07 | $112.20 | $549.54 |
Cigna Setting Professional Modifier None Typical Low $85.11 Median $123.03 Typical High $208.93 | Professional | None | $85.11 | $123.03 | $208.93 |
Florida Blue Setting Facility Modifier None Typical Low $60.26 Median $131.83 Typical High $4,570.88 | Facility | None | $60.26 | $131.83 | $4,570.88 |
Florida Blue Setting Professional Modifier None Typical Low $64.57 Median $141.25 Typical High $186.21 | Professional | None | $64.57 | $141.25 | $186.21 |
Molina Setting Professional Modifier None Typical Low $89.13 Median $144.54 Typical High $239.88 | Professional | None | $89.13 | $144.54 | $239.88 |
United Setting Facility Modifier None Typical Low $281.84 Median $660.69 Typical High $4,073.80 | Facility | None | $281.84 | $660.69 | $4,073.80 |
United Setting Professional Modifier None Typical Low $87.10 Median $120.23 Typical High $239.88 | Professional | None | $87.10 | $120.23 | $239.88 |
Wellpoint Setting Professional Modifier None Typical Low $81.28 Median $131.83 Typical High $131.83 | Professional | None | $81.28 | $131.83 | $131.83 |
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 $52.48 Median $66.07 Typical High $77.62 | Professional | 52 · Reduced service | $52.48 | $66.07 | $77.62 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $20.89 Median $26.30 Typical High $31.62 | Professional | 53 · Discontinued | $20.89 | $26.30 | $31.62 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $77.62 Median $97.72 Typical High $117.49 | Professional | 54 · Surgery only | $77.62 | $97.72 | $117.49 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $15.49 Median $19.50 Typical High $23.44 | Professional | 55 · Aftercare only | $15.49 | $19.50 | $23.44 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $10.47 Median $13.18 Typical High $15.49 | Professional | 56 · Pre-op care only | $10.47 | $13.18 | $15.49 |
Where Florida sits
The same service costs 3.5 times more in Alaska than in Florida. 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· 51st of 51
$132
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.