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 $50.12 Median $3,019.95 Typical High $12,022.64 | Facility | None | $50.12 | $3,019.95 | $12,022.64 |
Aetna Setting Professional Modifier None Typical Low $38.02 Median $50.12 Typical High $79.43 | Professional | None | $38.02 | $50.12 | $79.43 |
Ambetter Setting Professional Modifier None Typical Low $64.57 Median $72.44 Typical High $120.23 | Professional | None | $64.57 | $72.44 | $120.23 |
AvMed Setting Facility Modifier None Typical Low $54.95 Median $2,137.96 Typical High $11,748.98 | Facility | None | $54.95 | $2,137.96 | $11,748.98 |
AvMed Setting Professional Modifier None Typical Low $41.69 Median $54.95 Typical High $69.18 | Professional | None | $41.69 | $54.95 | $69.18 |
Cigna Setting Facility Modifier None Typical Low $50.12 Median $66.07 Typical High $724.44 | Facility | None | $50.12 | $66.07 | $724.44 |
Cigna Setting Professional Modifier None Typical Low $34.67 Median $47.86 Typical High $85.11 | Professional | None | $34.67 | $47.86 | $85.11 |
Florida Blue Setting Facility Modifier None Typical Low $34.67 Median $70.79 Typical High $2,137.96 | Facility | None | $34.67 | $70.79 | $2,137.96 |
Florida Blue Setting Professional Modifier None Typical Low $31.62 Median $50.12 Typical High $93.33 | Professional | None | $31.62 | $50.12 | $93.33 |
Molina Setting Professional Modifier None Typical Low $45.71 Median $60.26 Typical High $102.33 | Professional | None | $45.71 | $60.26 | $102.33 |
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 $38.02 Median $53.70 Typical High $95.50 | Professional | None | $38.02 | $53.70 | $95.50 |
Wellpoint Setting Professional Modifier None Typical Low $33.88 Median $63.10 Typical High $63.10 | Professional | None | $33.88 | $63.10 | $63.10 |
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 $19.05 Median $25.12 Typical High $33.11 | Professional | 52 · Reduced service | $19.05 | $25.12 | $33.11 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $7.59 Median $10.23 Typical High $13.18 | Professional | 53 · Discontinued | $7.59 | $10.23 | $13.18 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $28.84 Median $38.02 Typical High $48.98 | Professional | 54 · Surgery only | $28.84 | $38.02 | $48.98 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $5.75 Median $7.59 Typical High $9.77 | Professional | 55 · Aftercare only | $5.75 | $7.59 | $9.77 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $3.80 Median $5.13 Typical High $6.61 | Professional | 56 · Pre-op care only | $3.80 | $5.13 | $6.61 |
Where Florida sits
The same service costs 3.6 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
$54.95
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.