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 $338.84 Median $2,951.21 Typical High $10,964.78 | Facility | None | $338.84 | $2,951.21 | $10,964.78 |
Aetna Setting Professional Modifier None Typical Low $21.88 Median $28.84 Typical High $39.81 | Professional | None | $21.88 | $28.84 | $39.81 |
Ambetter Setting Professional Modifier None Typical Low $20.89 Median $20.89 Typical High $40.74 | Professional | None | $20.89 | $20.89 | $40.74 |
AvMed Setting Facility Modifier None Typical Low $28.84 Median $2,137.96 Typical High $11,748.98 | Facility | None | $28.84 | $2,137.96 | $11,748.98 |
AvMed Setting Professional Modifier None Typical Low $23.99 Median $28.84 Typical High $38.02 | Professional | None | $23.99 | $28.84 | $38.02 |
Cigna Setting Facility Modifier None Typical Low $331.13 Median $851.14 Typical High $2,691.53 | Facility | None | $331.13 | $851.14 | $2,691.53 |
Cigna Setting Professional Modifier None Typical Low $19.05 Median $24.55 Typical High $42.66 | Professional | None | $19.05 | $24.55 | $42.66 |
Florida Blue Setting Facility Modifier None Typical Low $33.88 Median $61.66 Typical High $2,089.30 | Facility | None | $33.88 | $61.66 | $2,089.30 |
Florida Blue Setting Professional Modifier None Typical Low $23.99 Median $26.92 Typical High $39.81 | Professional | None | $23.99 | $26.92 | $39.81 |
Molina Setting Professional Modifier None Typical Low $16.98 Median $26.30 Typical High $39.81 | Professional | None | $16.98 | $26.30 | $39.81 |
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 $19.05 Median $26.30 Typical High $50.12 | Professional | None | $19.05 | $26.30 | $50.12 |
Wellpoint Setting Professional Modifier None Typical Low $16.98 Median $26.30 Typical High $26.30 | Professional | None | $16.98 | $26.30 | $26.30 |
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 $10.72 Median $13.80 Typical High $15.14 | Professional | 52 · Reduced service | $10.72 | $13.80 | $15.14 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $4.27 Median $5.62 Typical High $6.03 | Professional | 53 · Discontinued | $4.27 | $5.62 | $6.03 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $16.22 Median $20.89 Typical High $22.39 | Professional | 54 · Surgery only | $16.22 | $20.89 | $22.39 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $3.24 Median $4.17 Typical High $4.47 | Professional | 55 · Aftercare only | $3.24 | $4.17 | $4.47 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $2.14 Median $2.75 Typical High $3.02 | Professional | 56 · Pre-op care only | $2.14 | $2.75 | $3.02 |
Where Florida sits
The same service costs 3.5 times more in Alaska than in New Jersey. 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
$30.20
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.