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 $100.00 Median $2,884.03 Typical High $10,964.78 | Facility | None | $100.00 | $2,884.03 | $10,964.78 |
Aetna Setting Professional Modifier None Typical Low $69.18 Median $85.11 Typical High $141.25 | Professional | None | $69.18 | $85.11 | $141.25 |
Ambetter Setting Professional Modifier None Typical Low $93.33 Median $112.20 Typical High $204.17 | Professional | None | $93.33 | $112.20 | $204.17 |
AvMed Setting Facility Modifier None Typical Low $95.50 Median $1,513.56 Typical High $9,772.37 | Facility | None | $95.50 | $1,513.56 | $9,772.37 |
AvMed Setting Professional Modifier None Typical Low $75.86 Median $95.50 Typical High $151.36 | Professional | None | $75.86 | $95.50 | $151.36 |
Cigna Setting Facility Modifier None Typical Low $63.10 Median $125.89 Typical High $1,659.59 | Facility | None | $63.10 | $125.89 | $1,659.59 |
Cigna Setting Professional Modifier None Typical Low $63.10 Median $81.28 Typical High $162.18 | Professional | None | $63.10 | $81.28 | $162.18 |
Florida Blue Setting Facility Modifier None Typical Low $64.57 Median $131.83 Typical High $3,019.95 | Facility | None | $64.57 | $131.83 | $3,019.95 |
Florida Blue Setting Professional Modifier None Typical Low $79.43 Median $104.71 Typical High $245.47 | Professional | None | $79.43 | $104.71 | $245.47 |
Molina Setting Professional Modifier None Typical Low $69.18 Median $97.72 Typical High $154.88 | Professional | None | $69.18 | $97.72 | $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 $67.61 Median $93.33 Typical High $190.55 | Professional | None | $67.61 | $93.33 | $190.55 |
Wellpoint Setting Professional Modifier None Typical Low $63.10 Median $104.71 Typical High $104.71 | Professional | None | $63.10 | $104.71 | $104.71 |
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 $34.67 Median $42.66 Typical High $57.54 | Professional | 52 · Reduced service | $34.67 | $42.66 | $57.54 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $13.80 Median $16.98 Typical High $22.91 | Professional | 53 · Discontinued | $13.80 | $16.98 | $22.91 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $51.29 Median $63.10 Typical High $85.11 | Professional | 54 · Surgery only | $51.29 | $63.10 | $85.11 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $10.47 Median $12.59 Typical High $16.98 | Professional | 55 · Aftercare only | $10.47 | $12.59 | $16.98 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $6.92 Median $8.51 Typical High $11.48 | Professional | 56 · Pre-op care only | $6.92 | $8.51 | $11.48 |
Where Florida sits
The same service costs 3.7 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
$97.72
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.