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 $354.81 Median $3,019.95 Typical High $10,964.78 | Facility | None | $354.81 | $3,019.95 | $10,964.78 |
Aetna Setting Professional Modifier None Typical Low $39.81 Median $47.86 Typical High $72.44 | Professional | None | $39.81 | $47.86 | $72.44 |
AvMed Setting Facility Modifier None Typical Low $50.12 Median $6,025.60 Typical High $13,182.57 | Facility | None | $50.12 | $6,025.60 | $13,182.57 |
AvMed Setting Professional Modifier None Typical Low $45.71 Median $56.23 Typical High $63.10 | Professional | None | $45.71 | $56.23 | $63.10 |
Cigna Setting Facility Modifier None Typical Low $79.43 Median $79.43 Typical High $79.43 | Facility | None | $79.43 | $79.43 | $79.43 |
Cigna Setting Professional Modifier None Typical Low $38.02 Median $54.95 Typical High $114.82 | Professional | None | $38.02 | $54.95 | $114.82 |
Florida Blue Setting Facility Modifier None Typical Low $51.29 Median $53.70 Typical High $58.88 | Facility | None | $51.29 | $53.70 | $58.88 |
Florida Blue Setting Professional Modifier None Typical Low $35.48 Median $66.07 Typical High $389.05 | Professional | None | $35.48 | $66.07 | $389.05 |
Molina Setting Professional Modifier None Typical Low $47.86 Median $53.70 Typical High $134.90 | Professional | None | $47.86 | $53.70 | $134.90 |
United Setting Facility Modifier None Typical Low $169.82 Median $1,819.70 Typical High $5,248.07 | Facility | None | $169.82 | $1,819.70 | $5,248.07 |
United Setting Professional Modifier None Typical Low $43.65 Median $60.26 Typical High $120.23 | Professional | None | $43.65 | $60.26 | $120.23 |
Wellpoint Setting Professional Modifier None Typical Low $35.48 Median $43.65 Typical High $43.65 | Professional | None | $35.48 | $43.65 | $43.65 |
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 $19.95 Median $23.99 Typical High $36.31 | Professional | 52 · Reduced service | $19.95 | $23.99 | $36.31 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $7.94 Median $9.55 Typical High $14.45 | Professional | 53 · Discontinued | $7.94 | $9.55 | $14.45 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $30.20 Median $36.31 Typical High $53.70 | Professional | 54 · Surgery only | $30.20 | $36.31 | $53.70 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $6.03 Median $7.24 Typical High $10.72 | Professional | 55 · Aftercare only | $6.03 | $7.24 | $10.72 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $3.98 Median $4.79 Typical High $7.24 | Professional | 56 · Pre-op care only | $3.98 | $4.79 | $7.24 |
Where Florida sits
The same service costs 3.4 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
$53.70
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.