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 $81.28 Median $114.82 Typical High $154.88 | Professional | None | $81.28 | $114.82 | $154.88 |
Ambetter Setting Professional Modifier None Typical Low $107.15 Median $107.15 Typical High $134.90 | Professional | None | $107.15 | $107.15 | $134.90 |
AvMed Setting Facility Modifier None Typical Low $95.50 Median $2,137.96 Typical High $11,748.98 | Facility | None | $95.50 | $2,137.96 | $11,748.98 |
AvMed Setting Professional Modifier None Typical Low $89.13 Median $123.03 Typical High $165.96 | Professional | None | $89.13 | $123.03 | $165.96 |
Cigna Setting Facility Modifier None Typical Low $77.62 Median $154.88 Typical High $1,659.59 | Facility | None | $77.62 | $154.88 | $1,659.59 |
Cigna Setting Professional Modifier None Typical Low $70.79 Median $104.71 Typical High $165.96 | Professional | None | $70.79 | $104.71 | $165.96 |
Florida Blue Setting Facility Modifier None Typical Low $64.57 Median $131.83 Typical High $4,466.84 | Facility | None | $64.57 | $131.83 | $4,466.84 |
Florida Blue Setting Professional Modifier None Typical Low $104.71 Median $117.49 Typical High $169.82 | Professional | None | $104.71 | $117.49 | $169.82 |
Molina Setting Professional Modifier None Typical Low $69.18 Median $114.82 Typical High $177.83 | Professional | None | $69.18 | $114.82 | $177.83 |
United Setting Facility Modifier None Typical Low $281.84 Median $660.69 Typical High $4,073.80 | Facility | None | $281.84 | $660.69 | $4,073.80 |
United Setting Professional Modifier None Typical Low $64.57 Median $104.71 Typical High $190.55 | Professional | None | $64.57 | $104.71 | $190.55 |
Wellpoint Setting Professional Modifier None Typical Low $63.10 Median $114.82 Typical High $114.82 | Professional | None | $63.10 | $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 $39.81 Median $54.95 Typical High $61.66 | Professional | 52 · Reduced service | $39.81 | $54.95 | $61.66 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $15.85 Median $22.39 Typical High $24.55 | Professional | 53 · Discontinued | $15.85 | $22.39 | $24.55 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $60.26 Median $83.18 Typical High $91.20 | Professional | 54 · Surgery only | $60.26 | $83.18 | $91.20 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $12.02 Median $16.60 Typical High $18.20 | Professional | 55 · Aftercare only | $12.02 | $16.60 | $18.20 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $7.94 Median $11.22 Typical High $12.30 | Professional | 56 · Pre-op care only | $7.94 | $11.22 | $12.30 |
Where Florida sits
The same service costs 3.2 times more in Alaska than in Florida. 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· 51st of 51
$117
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.