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 $58.88 Median $3,311.31 Typical High $12,022.64 | Facility | None | $58.88 | $3,311.31 | $12,022.64 |
Aetna Setting Professional Modifier None Typical Low $41.69 Median $56.23 Typical High $67.61 | Professional | None | $41.69 | $56.23 | $67.61 |
AvMed Setting Facility Modifier None Typical Low $54.95 Median $2,137.96 Typical High $11,748.98 | Facility | None | $54.95 | $2,137.96 | $11,748.98 |
AvMed Setting Professional Modifier None Typical Low $48.98 Median $70.79 Typical High $93.33 | Professional | None | $48.98 | $70.79 | $93.33 |
Cigna Setting Facility Modifier None Typical Low $50.12 Median $66.07 Typical High $120.23 | Facility | None | $50.12 | $66.07 | $120.23 |
Cigna Setting Professional Modifier None Typical Low $40.74 Median $57.54 Typical High $91.20 | Professional | None | $40.74 | $57.54 | $91.20 |
Florida Blue Setting Facility Modifier None Typical Low $33.88 Median $70.79 Typical High $3,019.95 | Facility | None | $33.88 | $70.79 | $3,019.95 |
Florida Blue Setting Professional Modifier None Typical Low $61.66 Median $69.18 Typical High $100.00 | Professional | None | $61.66 | $69.18 | $100.00 |
Molina Setting Professional Modifier None Typical Low $83.18 Median $109.65 Typical High $144.54 | Professional | None | $83.18 | $109.65 | $144.54 |
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 $38.02 Median $56.23 Typical High $104.71 | Professional | None | $38.02 | $56.23 | $104.71 |
Wellpoint Setting Professional Modifier None Typical Low $44.67 Median $89.13 Typical High $89.13 | Professional | None | $44.67 | $89.13 | $89.13 |
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 $28.18 Typical High $33.88 | Professional | 52 · Reduced service | $20.89 | $28.18 | $33.88 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $8.32 Median $11.22 Typical High $13.49 | Professional | 53 · Discontinued | $8.32 | $11.22 | $13.49 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $31.62 Median $41.69 Typical High $50.12 | Professional | 54 · Surgery only | $31.62 | $41.69 | $50.12 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $6.31 Median $8.32 Typical High $10.00 | Professional | 55 · Aftercare only | $6.31 | $8.32 | $10.00 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $4.17 Median $5.62 Typical High $6.76 | Professional | 56 · Pre-op care only | $4.17 | $5.62 | $6.76 |
Where Florida sits
The same service costs 3.4 times more in Alaska 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· 48th of 51
$66.07
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.