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 $870.96 Median $6,309.57 Typical High $14,125.38 | Facility | None | $870.96 | $6,309.57 | $14,125.38 |
Aetna Setting Professional Modifier None Typical Low $501.19 Median $831.76 Typical High $891.25 | Professional | None | $501.19 | $831.76 | $891.25 |
AvMed Setting Facility Modifier None Typical Low $281.84 Median $19,498.45 Typical High $22,908.68 | Facility | None | $281.84 | $19,498.45 | $22,908.68 |
AvMed Setting Professional Modifier None Typical Low $281.84 Median $346.74 Typical High $407.38 | Professional | None | $281.84 | $346.74 | $407.38 |
Cigna Setting Facility Modifier None Typical Low $489.78 Median $19,498.45 Typical High $37,153.52 | Facility | None | $489.78 | $19,498.45 | $37,153.52 |
Cigna Setting Professional Modifier None Typical Low $1,778.28 Median $1,778.28 Typical High $1,778.28 | Professional | None | $1,778.28 | $1,778.28 | $1,778.28 |
Florida Blue Setting Facility Modifier None Typical Low $2,818.38 Median $5,370.32 Typical High $954,992.59 | Facility | None | $2,818.38 | $5,370.32 | $954,992.59 |
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 $338.84 Median $575.44 Typical High $1,174.90 | Professional | None | $338.84 | $575.44 | $1,174.90 |
Wellpoint Setting Professional Modifier None Typical Low $331.13 Median $331.13 Typical High $371.54 | Professional | None | $331.13 | $331.13 | $371.54 |
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 $251.19 Median $416.87 Typical High $446.68 | Professional | 52 · Reduced service | $251.19 | $416.87 | $446.68 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $100.00 Median $169.82 Typical High $177.83 | Professional | 53 · Discontinued | $100.00 | $169.82 | $177.83 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $380.19 Median $630.96 Typical High $676.08 | Professional | 54 · Surgery only | $380.19 | $630.96 | $676.08 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $75.86 Median $125.89 Typical High $134.90 | Professional | 55 · Aftercare only | $75.86 | $125.89 | $134.90 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $50.12 Median $83.18 Typical High $89.13 | Professional | 56 · Pre-op care only | $50.12 | $83.18 | $89.13 |
Where Florida sits
The same service costs 50.1 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· 9th of 51
$4,786
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.