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 $380.19 Median $630.96 Typical High $676.08 | Professional | None | $380.19 | $630.96 | $676.08 |
AvMed Setting Facility Modifier None Typical Low $380.19 Median $2,137.96 Typical High $14,791.08 | Facility | None | $380.19 | $2,137.96 | $14,791.08 |
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 $14,125.38 Typical High $26,915.35 | Facility | None | $478.63 | $14,125.38 | $26,915.35 |
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 $4,677.35 Typical High $8,511.38 | Facility | None | $2,691.53 | $4,677.35 | $8,511.38 |
Florida Blue Setting Professional Modifier None Typical Low $331.13 Median $446.68 Typical High $512.86 | Professional | None | $331.13 | $446.68 | $512.86 |
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 $512.86 Median $758.58 Typical High $1,584.89 | Professional | None | $512.86 | $758.58 | $1,584.89 |
Wellpoint Setting Professional Modifier None Typical Low $467.74 Median $467.74 Typical High $467.74 | Professional | None | $467.74 | $467.74 | $467.74 |
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 $190.55 Median $316.23 Typical High $338.84 | Professional | 52 · Reduced service | $190.55 | $316.23 | $338.84 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $75.86 Median $125.89 Typical High $134.90 | Professional | 53 · Discontinued | $75.86 | $125.89 | $134.90 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $281.84 Median $467.74 Typical High $501.19 | Professional | 54 · Surgery only | $281.84 | $467.74 | $501.19 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $56.23 Median $95.50 Typical High $100.00 | Professional | 55 · Aftercare only | $56.23 | $95.50 | $100.00 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $38.02 Median $63.10 Typical High $67.61 | Professional | 56 · Pre-op care only | $38.02 | $63.10 | $67.61 |
Where Florida sits
The same service costs 27.5 times more in Oklahoma 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· 12th of 51
$3,467
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.