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 $125.89 Median $3,311.31 Typical High $12,022.64 | Facility | None | $125.89 | $3,311.31 | $12,022.64 |
Aetna Setting Professional Modifier None Typical Low $61.66 Median $100.00 Typical High $158.49 | Professional | None | $61.66 | $100.00 | $158.49 |
Ambetter Setting Professional Modifier None Typical Low $112.20 Median $131.83 Typical High $138.04 | Professional | None | $112.20 | $131.83 | $138.04 |
AvMed Setting Facility Modifier None Typical Low $123.03 Median $2,137.96 Typical High $11,748.98 | Facility | None | $123.03 | $2,137.96 | $11,748.98 |
AvMed Setting Professional Modifier None Typical Low $61.66 Median $120.23 Typical High $158.49 | Professional | None | $61.66 | $120.23 | $158.49 |
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 $52.48 Median $104.71 Typical High $158.49 | Professional | None | $52.48 | $104.71 | $158.49 |
Florida Blue Setting Facility Modifier None Typical Low $64.57 Median $138.04 Typical High $3,981.07 | Facility | None | $64.57 | $138.04 | $3,981.07 |
Florida Blue Setting Professional Modifier None Typical Low $100.00 Median $109.65 Typical High $162.18 | Professional | None | $100.00 | $109.65 | $162.18 |
Molina Setting Professional Modifier None Typical Low $53.70 Median $114.82 Typical High $181.97 | Professional | None | $53.70 | $114.82 | $181.97 |
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 $51.29 Median $95.50 Typical High $169.82 | Professional | None | $51.29 | $95.50 | $169.82 |
Wellpoint Setting Professional Modifier None Typical Low $48.98 Median $114.82 Typical High $114.82 | Professional | None | $48.98 | $114.82 | $114.82 |
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 $30.90 Median $50.12 Typical High $66.07 | Professional | 52 · Reduced service | $30.90 | $50.12 | $66.07 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $12.30 Median $19.95 Typical High $26.92 | Professional | 53 · Discontinued | $12.30 | $19.95 | $26.92 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $45.71 Median $75.86 Typical High $100.00 | Professional | 54 · Surgery only | $45.71 | $75.86 | $100.00 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $9.12 Median $15.14 Typical High $19.95 | Professional | 55 · Aftercare only | $9.12 | $15.14 | $19.95 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $6.17 Median $10.00 Typical High $13.49 | Professional | 56 · Pre-op care only | $6.17 | $10.00 | $13.49 |
Where Florida sits
The same service costs 3.5 times more in Alaska than in Maryland. 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· 48th of 51
$112
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.