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 $51.29 Median $2,344.23 Typical High $10,715.19 | Facility | None | $51.29 | $2,344.23 | $10,715.19 |
Aetna Setting Professional Modifier None Typical Low $42.66 Median $51.29 Typical High $85.11 | Professional | None | $42.66 | $51.29 | $85.11 |
Ambetter Setting Professional Modifier None Typical Low $44.67 Median $60.26 Typical High $77.62 | Professional | None | $44.67 | $60.26 | $77.62 |
AvMed Setting Facility Modifier None Typical Low $51.29 Median $2,137.96 Typical High $11,748.98 | Facility | None | $51.29 | $2,137.96 | $11,748.98 |
AvMed Setting Professional Modifier None Typical Low $45.71 Median $53.70 Typical High $66.07 | Professional | None | $45.71 | $53.70 | $66.07 |
Cigna Setting Facility Modifier None Typical Low $446.68 Median $1,047.13 Typical High $2,691.53 | Facility | None | $446.68 | $1,047.13 | $2,691.53 |
Cigna Setting Professional Modifier None Typical Low $37.15 Median $54.95 Typical High $102.33 | Professional | None | $37.15 | $54.95 | $102.33 |
Florida Blue Setting Facility Modifier None Typical Low $208.93 Median $380.19 Typical High $2,089.30 | Facility | None | $208.93 | $380.19 | $2,089.30 |
Florida Blue Setting Professional Modifier None Typical Low $42.66 Median $45.71 Typical High $64.57 | Professional | None | $42.66 | $45.71 | $64.57 |
Molina Setting Professional Modifier None Typical Low $51.29 Median $74.13 Typical High $141.25 | Professional | None | $51.29 | $74.13 | $141.25 |
United Setting Facility Modifier None Typical Low $81.28 Median $302.00 Typical High $2,818.38 | Facility | None | $81.28 | $302.00 | $2,818.38 |
United Setting Professional Modifier None Typical Low $42.66 Median $64.57 Typical High $120.23 | Professional | None | $42.66 | $64.57 | $120.23 |
Wellpoint Setting Professional Modifier None Typical Low $33.88 Median $46.77 Typical High $46.77 | Professional | None | $33.88 | $46.77 | $46.77 |
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 $20.89 Median $23.99 Typical High $27.54 | Professional | 52 · Reduced service | $20.89 | $23.99 | $27.54 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $8.32 Median $9.55 Typical High $10.96 | Professional | 53 · Discontinued | $8.32 | $9.55 | $10.96 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $31.62 Median $36.31 Typical High $40.74 | Professional | 54 · Surgery only | $31.62 | $36.31 | $40.74 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $6.31 Median $7.24 Typical High $8.13 | Professional | 55 · Aftercare only | $6.31 | $7.24 | $8.13 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $4.17 Median $4.79 Typical High $5.50 | Professional | 56 · Pre-op care only | $4.17 | $4.79 | $5.50 |
Where Florida sits
The same service costs 4.8 times more in Alaska than in Kentucky. 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· 29th of 51
$72.44
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.