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 $251.19 Median $416.87 Typical High $446.68 | Professional | None | $251.19 | $416.87 | $446.68 |
AvMed Setting Facility Modifier None Typical Low $295.12 Median $2,137.96 Typical High $18,620.87 | Facility | None | $295.12 | $2,137.96 | $18,620.87 |
AvMed Setting Professional Modifier None Typical Low $275.42 Median $346.74 Typical High $398.11 | Professional | None | $275.42 | $346.74 | $398.11 |
Cigna Setting Facility Modifier None Typical Low $501.19 Median $17,782.79 Typical High $33,884.42 | Facility | None | $501.19 | $17,782.79 | $33,884.42 |
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 $4,466.84 Typical High $8,128.31 | Facility | None | $2,691.53 | $4,466.84 | $8,128.31 |
Florida Blue Setting Professional Modifier None Typical Low $257.04 Median $346.74 Typical High $398.11 | Professional | None | $257.04 | $346.74 | $398.11 |
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 $346.74 Median $524.81 Typical High $1,071.52 | Professional | None | $346.74 | $524.81 | $1,071.52 |
Wellpoint Setting Professional Modifier None Typical Low $398.11 Median $398.11 Typical High $398.11 | Professional | None | $398.11 | $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 $123.03 Median $208.93 Typical High $218.78 | Professional | 52 · Reduced service | $123.03 | $208.93 | $218.78 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $50.12 Median $83.18 Typical High $89.13 | Professional | 53 · Discontinued | $50.12 | $83.18 | $89.13 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $186.21 Median $309.03 Typical High $331.13 | Professional | 54 · Surgery only | $186.21 | $309.03 | $331.13 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $37.15 Median $61.66 Typical High $66.07 | Professional | 55 · Aftercare only | $37.15 | $61.66 | $66.07 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $25.12 Median $41.69 Typical High $44.67 | Professional | 56 · Pre-op care only | $25.12 | $41.69 | $44.67 |
Where Florida sits
The same service costs 57.5 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· 14th 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.