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 $354.81 Median $3,019.95 Typical High $10,964.78 | Facility | None | $354.81 | $3,019.95 | $10,964.78 |
Aetna Setting Professional Modifier None Typical Low $19.50 Median $43.65 Typical High $75.86 | Professional | None | $19.50 | $43.65 | $75.86 |
Ambetter Setting Professional Modifier None Typical Low $58.88 Median $75.86 Typical High $77.62 | Professional | None | $58.88 | $75.86 | $77.62 |
AvMed Setting Facility Modifier None Typical Low $64.57 Median $2,137.96 Typical High $11,748.98 | Facility | None | $64.57 | $2,137.96 | $11,748.98 |
AvMed Setting Professional Modifier None Typical Low $20.89 Median $64.57 Typical High $83.18 | Professional | None | $20.89 | $64.57 | $83.18 |
Cigna Setting Facility Modifier None Typical Low $50.12 Median $66.07 Typical High $724.44 | Facility | None | $50.12 | $66.07 | $724.44 |
Cigna Setting Professional Modifier None Typical Low $16.22 Median $50.12 Typical High $81.28 | Professional | None | $16.22 | $50.12 | $81.28 |
Florida Blue Setting Facility Modifier None Typical Low $34.67 Median $74.13 Typical High $3,019.95 | Facility | None | $34.67 | $74.13 | $3,019.95 |
Florida Blue Setting Professional Modifier None Typical Low $30.20 Median $57.54 Typical High $87.10 | Professional | None | $30.20 | $57.54 | $87.10 |
Molina Setting Professional Modifier None Typical Low $16.98 Median $63.10 Typical High $95.50 | Professional | None | $16.98 | $63.10 | $95.50 |
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 $16.98 Median $42.66 Typical High $75.86 | Professional | None | $16.98 | $42.66 | $75.86 |
Wellpoint Setting Professional Modifier None Typical Low $15.49 Median $63.10 Typical High $63.10 | Professional | None | $15.49 | $63.10 | $63.10 |
6 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 $9.55 Median $21.88 Typical High $24.55 | Professional | 52 · Reduced service | $9.55 | $21.88 | $24.55 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $3.80 Median $8.71 Typical High $9.77 | Professional | 53 · Discontinued | $3.80 | $8.71 | $9.77 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $14.45 Median $33.11 Typical High $36.31 | Professional | 54 · Surgery only | $14.45 | $33.11 | $36.31 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $2.88 Median $6.61 Typical High $7.24 | Professional | 55 · Aftercare only | $2.88 | $6.61 | $7.24 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $1.91 Median $4.37 Typical High $4.90 | Professional | 56 · Pre-op care only | $1.91 | $4.37 | $4.90 |
Ambetter Setting Professional Modifier Q8 · Foot care: two class B findings Typical Low $64.57 Median $64.57 Typical High $79.43 | Professional | Q8 · Foot care: two class B findings | $64.57 | $64.57 | $79.43 |
Where Florida sits
The same service costs 3.4 times more in Wisconsin 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· 41st of 51
$56.23
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.