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 $3,090.30 Typical High $11,481.54 | Facility | None | $354.81 | $3,090.30 | $11,481.54 |
Aetna Setting Professional Modifier None Typical Low $53.70 Median $131.83 Typical High $173.78 | Professional | None | $53.70 | $131.83 | $173.78 |
Ambetter Setting Professional Modifier None Typical Low $112.20 Median $131.83 Typical High $138.04 | Professional | None | $112.20 | $131.83 | $138.04 |
AvMed Setting Facility Modifier None Typical Low $114.82 Median $1,445.44 Typical High $2,137.96 | Facility | None | $114.82 | $1,445.44 | $2,137.96 |
AvMed Setting Professional Modifier None Typical Low $47.86 Median $120.23 Typical High $169.82 | Professional | None | $47.86 | $120.23 | $169.82 |
Cigna Setting Facility Modifier None Typical Low $77.62 Median $363.08 Typical High $426.58 | Facility | None | $77.62 | $363.08 | $426.58 |
Cigna Setting Professional Modifier None Typical Low $51.29 Median $117.49 Typical High $181.97 | Professional | None | $51.29 | $117.49 | $181.97 |
Florida Blue Setting Facility Modifier None Typical Low $213.80 Median $257.04 Typical High $257.04 | Facility | None | $213.80 | $257.04 | $257.04 |
Florida Blue Setting Professional Modifier None Typical Low $100.00 Median $112.20 Typical High $165.96 | Professional | None | $100.00 | $112.20 | $165.96 |
Molina Setting Professional Modifier None Typical Low $47.86 Median $151.36 Typical High $218.78 | Professional | None | $47.86 | $151.36 | $218.78 |
United Setting Facility Modifier None Typical Low $234.42 Median $251.19 Typical High $251.19 | Facility | None | $234.42 | $251.19 | $251.19 |
United Setting Professional Modifier None Typical Low $50.12 Median $109.65 Typical High $199.53 | Professional | None | $50.12 | $109.65 | $199.53 |
Wellpoint Setting Professional Modifier None Typical Low $43.65 Median $114.82 Typical High $114.82 | Professional | None | $43.65 | $114.82 | $114.82 |
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 $26.92 Median $64.57 Typical High $75.86 | Professional | 52 · Reduced service | $26.92 | $64.57 | $75.86 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $10.72 Median $26.30 Typical High $30.20 | Professional | 53 · Discontinued | $10.72 | $26.30 | $30.20 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $40.74 Median $97.72 Typical High $114.82 | Professional | 54 · Surgery only | $40.74 | $97.72 | $114.82 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $8.13 Median $19.50 Typical High $22.91 | Professional | 55 · Aftercare only | $8.13 | $19.50 | $22.91 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $5.37 Median $13.18 Typical High $15.14 | Professional | 56 · Pre-op care only | $5.37 | $13.18 | $15.14 |
Where Florida sits
The same service costs 3.5 times more in Alaska than in Maryland. 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· 48th of 51
$120
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.