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 $48.98 Median $75.86 Typical High $112.20 | Professional | None | $48.98 | $75.86 | $112.20 |
Ambetter Setting Professional Modifier None Typical Low $74.13 Median $87.10 Typical High $107.15 | Professional | None | $74.13 | $87.10 | $107.15 |
AvMed Setting Facility Modifier None Typical Low $81.28 Median $2,137.96 Typical High $11,748.98 | Facility | None | $81.28 | $2,137.96 | $11,748.98 |
AvMed Setting Professional Modifier None Typical Low $52.48 Median $85.11 Typical High $107.15 | Professional | None | $52.48 | $85.11 | $107.15 |
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 $42.66 Median $67.61 Typical High $109.65 | Professional | None | $42.66 | $67.61 | $109.65 |
Florida Blue Setting Facility Modifier None Typical Low $34.67 Median $74.13 Typical High $3,981.07 | Facility | None | $34.67 | $74.13 | $3,981.07 |
Florida Blue Setting Professional Modifier None Typical Low $67.61 Median $75.86 Typical High $112.20 | Professional | None | $67.61 | $75.86 | $112.20 |
Molina Setting Professional Modifier None Typical Low $77.62 Median $104.71 Typical High $144.54 | Professional | None | $77.62 | $104.71 | $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 $40.74 Median $69.18 Typical High $123.03 | Professional | None | $40.74 | $69.18 | $123.03 |
Wellpoint Setting Professional Modifier None Typical Low $48.98 Median $95.50 Typical High $95.50 | Professional | None | $48.98 | $95.50 | $95.50 |
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 $23.99 Median $37.15 Typical High $41.69 | Professional | 52 · Reduced service | $23.99 | $37.15 | $41.69 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $9.55 Median $14.79 Typical High $16.98 | Professional | 53 · Discontinued | $9.55 | $14.79 | $16.98 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $35.48 Median $54.95 Typical High $63.10 | Professional | 54 · Surgery only | $35.48 | $54.95 | $63.10 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $7.08 Median $10.96 Typical High $12.59 | Professional | 55 · Aftercare only | $7.08 | $10.96 | $12.59 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $4.79 Median $7.41 Typical High $8.51 | Professional | 56 · Pre-op care only | $4.79 | $7.41 | $8.51 |
Where Florida sits
The same service costs 3.2 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· 50th of 51
$79.43
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.