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 $45.71 Median $3,311.31 Typical High $12,022.64 | Facility | None | $45.71 | $3,311.31 | $12,022.64 |
Aetna Setting Professional Modifier None Typical Low $35.48 Median $45.71 Typical High $60.26 | Professional | None | $35.48 | $45.71 | $60.26 |
AvMed Setting Facility Modifier None Typical Low $42.66 Median $2,137.96 Typical High $11,748.98 | Facility | None | $42.66 | $2,137.96 | $11,748.98 |
AvMed Setting Professional Modifier None Typical Low $39.81 Median $50.12 Typical High $63.10 | Professional | None | $39.81 | $50.12 | $63.10 |
Cigna Setting Facility Modifier None Typical Low $32.36 Median $50.12 Typical High $72.44 | Facility | None | $32.36 | $50.12 | $72.44 |
Cigna Setting Professional Modifier None Typical Low $32.36 Median $44.67 Typical High $81.28 | Professional | None | $32.36 | $44.67 | $81.28 |
Florida Blue Setting Facility Modifier None Typical Low $32.36 Median $70.79 Typical High $3,019.95 | Facility | None | $32.36 | $70.79 | $3,019.95 |
Florida Blue Setting Professional Modifier None Typical Low $28.18 Median $45.71 Typical High $83.18 | Professional | None | $28.18 | $45.71 | $83.18 |
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 $36.31 Median $48.98 Typical High $89.13 | Professional | None | $36.31 | $48.98 | $89.13 |
Wellpoint Setting Professional Modifier None Typical Low $33.11 Median $57.54 Typical High $57.54 | Professional | None | $33.11 | $57.54 | $57.54 |
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 $17.78 Median $22.91 Typical High $30.20 | Professional | 52 · Reduced service | $17.78 | $22.91 | $30.20 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $7.08 Median $9.12 Typical High $12.02 | Professional | 53 · Discontinued | $7.08 | $9.12 | $12.02 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $26.92 Median $34.67 Typical High $45.71 | Professional | 54 · Surgery only | $26.92 | $34.67 | $45.71 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $5.37 Median $6.92 Typical High $9.12 | Professional | 55 · Aftercare only | $5.37 | $6.92 | $9.12 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $3.55 Median $4.57 Typical High $6.03 | Professional | 56 · Pre-op care only | $3.55 | $4.57 | $6.03 |
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
$51.29
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.