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 $79.43 Median $3,311.31 Typical High $12,022.64 | Facility | None | $79.43 | $3,311.31 | $12,022.64 |
Aetna Setting Professional Modifier None Typical Low $46.77 Median $70.79 Typical High $123.03 | Professional | None | $46.77 | $70.79 | $123.03 |
Ambetter Setting Professional Modifier None Typical Low $64.57 Median $72.44 Typical High $87.10 | Professional | None | $64.57 | $72.44 | $87.10 |
AvMed Setting Facility Modifier None Typical Low $66.07 Median $2,137.96 Typical High $11,748.98 | Facility | None | $66.07 | $2,137.96 | $11,748.98 |
AvMed Setting Professional Modifier None Typical Low $51.29 Median $69.18 Typical High $134.90 | Professional | None | $51.29 | $69.18 | $134.90 |
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 $38.90 Median $66.07 Typical High $158.49 | Professional | None | $38.90 | $66.07 | $158.49 |
Florida Blue Setting Facility Modifier None Typical Low $34.67 Median $74.13 Typical High $3,019.95 | Facility | None | $34.67 | $74.13 | $3,019.95 |
Florida Blue Setting Professional Modifier None Typical Low $54.95 Median $60.26 Typical High $120.23 | Professional | None | $54.95 | $60.26 | $120.23 |
Molina Setting Professional Modifier None Typical Low $51.29 Median $70.79 Typical High $141.25 | Professional | None | $51.29 | $70.79 | $141.25 |
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 $44.67 Median $79.43 Typical High $165.96 | Professional | None | $44.67 | $79.43 | $165.96 |
Wellpoint Setting Professional Modifier None Typical Low $35.48 Median $61.66 Typical High $61.66 | Professional | None | $35.48 | $61.66 | $61.66 |
6 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 $22.91 Median $33.11 Typical High $51.29 | Professional | 52 · Reduced service | $22.91 | $33.11 | $51.29 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $9.12 Median $13.18 Typical High $20.89 | Professional | 53 · Discontinued | $9.12 | $13.18 | $20.89 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $33.88 Median $50.12 Typical High $77.62 | Professional | 54 · Surgery only | $33.88 | $50.12 | $77.62 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $6.76 Median $10.00 Typical High $15.49 | Professional | 55 · Aftercare only | $6.76 | $10.00 | $15.49 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $4.57 Median $6.61 Typical High $10.23 | Professional | 56 · Pre-op care only | $4.57 | $6.61 | $10.23 |
Ambetter Setting Professional Modifier 50 · Both sides Typical Low $112.20 Median $112.20 Typical High $112.20 | Professional | 50 · Both sides | $112.20 | $112.20 | $112.20 |
Where Florida sits
The same service costs 3.2 times more in Wisconsin than in Kentucky. 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· 50th of 51
$74.13
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.