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 $707.95 Median $4,073.80 Typical High $12,022.64 | Facility | None | $707.95 | $4,073.80 | $12,022.64 |
Aetna Setting Professional Modifier None Typical Low $1,047.13 Median $1,513.56 Typical High $1,621.81 | Professional | None | $1,047.13 | $1,513.56 | $1,621.81 |
AvMed Setting Facility Modifier None Typical Low $630.96 Median $2,137.96 Typical High $12,022.64 | Facility | None | $630.96 | $2,137.96 | $12,022.64 |
AvMed Setting Professional Modifier None Typical Low $891.25 Median $1,174.90 Typical High $1,288.25 | Professional | None | $891.25 | $1,174.90 | $1,288.25 |
Cigna Setting Facility Modifier None Typical Low $575.44 Median $11,748.98 Typical High $23,988.33 | Facility | None | $575.44 | $11,748.98 | $23,988.33 |
Cigna Setting Professional Modifier None Typical Low $2,344.23 Median $7,079.46 Typical High $7,079.46 | Professional | None | $2,344.23 | $7,079.46 | $7,079.46 |
Florida Blue Setting Facility Modifier None Typical Low $912.01 Median $1,621.81 Typical High $3,090.30 | Facility | None | $912.01 | $1,621.81 | $3,090.30 |
Florida Blue Setting Professional Modifier None Typical Low $776.25 Median $1,174.90 Typical High $1,737.80 | Professional | None | $776.25 | $1,174.90 | $1,737.80 |
Molina Setting Professional Modifier None Typical Low $50.12 Median $50.12 Typical High $50.12 | Professional | None | $50.12 | $50.12 | $50.12 |
United Setting Facility Modifier None Typical Low $3,630.78 Median $17,782.79 Typical High $35,481.34 | Facility | None | $3,630.78 | $17,782.79 | $35,481.34 |
United Setting Professional Modifier None Typical Low $977.24 Median $1,380.38 Typical High $2,290.87 | Professional | None | $977.24 | $1,380.38 | $2,290.87 |
Wellpoint Setting Professional Modifier None Typical Low $1,380.38 Median $13,489.63 Typical High $13,489.63 | Professional | None | $1,380.38 | $13,489.63 | $13,489.63 |
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 $524.81 Median $758.58 Typical High $812.83 | Professional | 52 · Reduced service | $524.81 | $758.58 | $812.83 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $213.80 Median $302.00 Typical High $323.59 | Professional | 53 · Discontinued | $213.80 | $302.00 | $323.59 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $794.33 Median $1,148.15 Typical High $1,230.27 | Professional | 54 · Surgery only | $794.33 | $1,148.15 | $1,230.27 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $158.49 Median $229.09 Typical High $245.47 | Professional | 55 · Aftercare only | $158.49 | $229.09 | $245.47 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $104.71 Median $151.36 Typical High $162.18 | Professional | 56 · Pre-op care only | $104.71 | $151.36 | $162.18 |
Where Florida sits
The same service costs 6.9 times more in Arkansas 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· 39th of 51
$1,622
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.