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 $87.10 Median $3,311.31 Typical High $12,022.64 | Facility | None | $87.10 | $3,311.31 | $12,022.64 |
Aetna Setting Professional Modifier None Typical Low $75.86 Median $87.10 Typical High $131.83 | Professional | None | $75.86 | $87.10 | $131.83 |
Ambetter Setting Professional Modifier None Typical Low $87.10 Median $87.10 Typical High $87.10 | Professional | None | $87.10 | $87.10 | $87.10 |
AvMed Setting Facility Modifier None Typical Low $95.50 Median $2,137.96 Typical High $11,748.98 | Facility | None | $95.50 | $2,137.96 | $11,748.98 |
AvMed Setting Professional Modifier None Typical Low $83.18 Median $95.50 Typical High $120.23 | Professional | None | $83.18 | $95.50 | $120.23 |
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 $69.18 Median $83.18 Typical High $158.49 | Professional | None | $69.18 | $83.18 | $158.49 |
Florida Blue Setting Facility Modifier None Typical Low $34.67 Median $74.13 Typical High $3,981.07 | Facility | None | $34.67 | $74.13 | $3,981.07 |
Florida Blue Setting Professional Modifier None Typical Low $47.86 Median $85.11 Typical High $147.91 | Professional | None | $47.86 | $85.11 | $147.91 |
Molina Setting Professional Modifier None Typical Low $72.44 Median $100.00 Typical High $154.88 | Professional | None | $72.44 | $100.00 | $154.88 |
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 $70.79 Median $93.33 Typical High $165.96 | Professional | None | $70.79 | $93.33 | $165.96 |
Wellpoint Setting Professional Modifier None Typical Low $69.18 Median $107.15 Typical High $107.15 | Professional | None | $69.18 | $107.15 | $107.15 |
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 $38.02 Median $42.66 Typical High $57.54 | Professional | 52 · Reduced service | $38.02 | $42.66 | $57.54 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $15.14 Median $17.38 Typical High $23.44 | Professional | 53 · Discontinued | $15.14 | $17.38 | $23.44 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $56.23 Median $64.57 Typical High $87.10 | Professional | 54 · Surgery only | $56.23 | $64.57 | $87.10 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $11.48 Median $12.88 Typical High $17.38 | Professional | 55 · Aftercare only | $11.48 | $12.88 | $17.38 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $7.59 Median $8.71 Typical High $11.48 | Professional | 56 · Pre-op care only | $7.59 | $8.71 | $11.48 |
Where Florida sits
The same service costs 4.5 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
$91.20
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.