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 $117.49 Median $3,311.31 Typical High $12,022.64 | Facility | None | $117.49 | $3,311.31 | $12,022.64 |
Aetna Setting Professional Modifier None Typical Low $54.95 Median $87.10 Typical High $147.91 | Professional | None | $54.95 | $87.10 | $147.91 |
Ambetter Setting Professional Modifier None Typical Low $117.49 Median $125.89 Typical High $128.82 | Professional | None | $117.49 | $125.89 | $128.82 |
AvMed Setting Facility Modifier None Typical Low $89.13 Median $2,137.96 Typical High $11,748.98 | Facility | None | $89.13 | $2,137.96 | $11,748.98 |
AvMed Setting Professional Modifier None Typical Low $54.95 Median $104.71 Typical High $141.25 | Professional | None | $54.95 | $104.71 | $141.25 |
Cigna Setting Facility Modifier None Typical Low $52.48 Median $100.00 Typical High $194.98 | Facility | None | $52.48 | $100.00 | $194.98 |
Cigna Setting Professional Modifier None Typical Low $46.77 Median $95.50 Typical High $144.54 | Professional | None | $46.77 | $95.50 | $144.54 |
Florida Blue Setting Facility Modifier None Typical Low $34.67 Median $70.79 Typical High $3,019.95 | Facility | None | $34.67 | $70.79 | $3,019.95 |
Florida Blue Setting Professional Modifier None Typical Low $87.10 Median $97.72 Typical High $144.54 | Professional | None | $87.10 | $97.72 | $144.54 |
Molina Setting Professional Modifier None Typical Low $46.77 Median $109.65 Typical High $177.83 | Professional | None | $46.77 | $109.65 | $177.83 |
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 $45.71 Median $89.13 Typical High $154.88 | Professional | None | $45.71 | $89.13 | $154.88 |
Wellpoint Setting Professional Modifier None Typical Low $42.66 Median $102.33 Typical High $102.33 | Professional | None | $42.66 | $102.33 | $102.33 |
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 $27.54 Median $43.65 Typical High $61.66 | Professional | 52 · Reduced service | $27.54 | $43.65 | $61.66 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $10.96 Median $17.38 Typical High $24.55 | Professional | 53 · Discontinued | $10.96 | $17.38 | $24.55 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $41.69 Median $66.07 Typical High $91.20 | Professional | 54 · Surgery only | $41.69 | $66.07 | $91.20 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $8.32 Median $13.18 Typical High $18.20 | Professional | 55 · Aftercare only | $8.32 | $13.18 | $18.20 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $5.50 Median $8.71 Typical High $12.30 | Professional | 56 · Pre-op care only | $5.50 | $8.71 | $12.30 |
Where Florida sits
The same service costs 3.1 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· 48th of 51
$100
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.