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 $776.25 Median $6,456.54 Typical High $15,135.61 | Facility | None | $776.25 | $6,456.54 | $15,135.61 |
Aetna Setting Professional Modifier None Typical Low $223.87 Median $371.54 Typical High $398.11 | Professional | None | $223.87 | $371.54 | $398.11 |
AvMed Setting Facility Modifier None Typical Low $281.84 Median $2,137.96 Typical High $19,498.45 | Facility | None | $281.84 | $2,137.96 | $19,498.45 |
AvMed Setting Professional Modifier None Typical Low $269.15 Median $338.84 Typical High $389.05 | Professional | None | $269.15 | $338.84 | $389.05 |
Cigna Setting Facility Modifier None Typical Low $501.19 Median $18,620.87 Typical High $34,673.69 | Facility | None | $501.19 | $18,620.87 | $34,673.69 |
Cigna Setting Professional Modifier None Typical Low $302.00 Median $302.00 Typical High $1,778.28 | Professional | None | $302.00 | $302.00 | $1,778.28 |
Florida Blue Setting Facility Modifier None Typical Low $2,691.53 Median $4,677.35 Typical High $9,120.11 | Facility | None | $2,691.53 | $4,677.35 | $9,120.11 |
Florida Blue Setting Professional Modifier None Typical Low $245.47 Median $338.84 Typical High $380.19 | Professional | None | $245.47 | $338.84 | $380.19 |
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 $5,128.61 Median $22,908.68 Typical High $51,286.14 | Facility | None | $5,128.61 | $22,908.68 | $51,286.14 |
United Setting Professional Modifier None Typical Low $316.23 Median $478.63 Typical High $977.24 | Professional | None | $316.23 | $478.63 | $977.24 |
Wellpoint Setting Professional Modifier None Typical Low $380.19 Median $398.11 Typical High $398.11 | Professional | None | $380.19 | $398.11 | $398.11 |
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 $112.20 Median $186.21 Typical High $199.53 | Professional | 52 · Reduced service | $112.20 | $186.21 | $199.53 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $44.67 Median $74.13 Typical High $79.43 | Professional | 53 · Discontinued | $44.67 | $74.13 | $79.43 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $165.96 Median $281.84 Typical High $295.12 | Professional | 54 · Surgery only | $165.96 | $281.84 | $295.12 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $33.88 Median $56.23 Typical High $60.26 | Professional | 55 · Aftercare only | $33.88 | $56.23 | $60.26 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $22.39 Median $37.15 Typical High $39.81 | Professional | 56 · Pre-op care only | $22.39 | $37.15 | $39.81 |
Where Florida sits
The same service costs 63.1 times more in Arkansas than in New York. 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· 13th of 51
$3,631
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.