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 $6,025.60 Typical High $12,302.69 | Facility | None | $776.25 | $6,025.60 | $12,302.69 |
Aetna Setting Professional Modifier None Typical Low $199.53 Median $331.13 Typical High $398.11 | Professional | None | $199.53 | $331.13 | $398.11 |
AvMed Setting Facility Modifier None Typical Low $354.81 Median $7,079.46 Typical High $10,964.78 | Facility | None | $354.81 | $7,079.46 | $10,964.78 |
AvMed Setting Professional Modifier None Typical Low $354.81 Median $446.68 Typical High $512.86 | Professional | None | $354.81 | $446.68 | $512.86 |
Cigna Setting Facility Modifier None Typical Low $478.63 Median $7,079.46 Typical High $13,489.63 | Facility | None | $478.63 | $7,079.46 | $13,489.63 |
Cigna Setting Professional Modifier None Typical Low $380.19 Median $380.19 Typical High $2,089.30 | Professional | None | $380.19 | $380.19 | $2,089.30 |
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 $331.13 Median $446.68 Typical High $467.74 | Professional | None | $331.13 | $446.68 | $467.74 |
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 $2,511.89 Median $10,000.00 Typical High $19,498.45 | Facility | None | $2,511.89 | $10,000.00 | $19,498.45 |
United Setting Professional Modifier None Typical Low $269.15 Median $446.68 Typical High $870.96 | Professional | None | $269.15 | $446.68 | $870.96 |
Wellpoint Setting Professional Modifier None Typical Low $467.74 Median $478.63 Typical High $478.63 | Professional | None | $467.74 | $478.63 | $478.63 |
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 $100.00 Median $165.96 Typical High $186.21 | Professional | 52 · Reduced service | $100.00 | $165.96 | $186.21 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $39.81 Median $66.07 Typical High $75.86 | Professional | 53 · Discontinued | $39.81 | $66.07 | $75.86 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $151.36 Median $251.19 Typical High $281.84 | Professional | 54 · Surgery only | $151.36 | $251.19 | $281.84 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $30.20 Median $50.12 Typical High $56.23 | Professional | 55 · Aftercare only | $30.20 | $50.12 | $56.23 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $19.95 Median $33.11 Typical High $37.15 | Professional | 56 · Pre-op care only | $19.95 | $33.11 | $37.15 |
Where Florida sits
The same service costs 16.2 times more in Arkansas than in West Virginia. 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· 6th 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.