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 $58.88 Median $109.65 Typical High $162.18 | Professional | None | $58.88 | $109.65 | $162.18 |
Ambetter Setting Professional Modifier None Typical Low $89.13 Median $194.98 Typical High $194.98 | Professional | None | $89.13 | $194.98 | $194.98 |
AvMed Setting Facility Modifier None Typical Low $181.97 Median $1,348.96 Typical High $9,549.93 | Facility | None | $181.97 | $1,348.96 | $9,549.93 |
AvMed Setting Professional Modifier None Typical Low $70.79 Median $134.90 Typical High $173.78 | Professional | None | $70.79 | $134.90 | $173.78 |
Cigna Setting Facility Modifier None Typical Low $323.59 Median $870.96 Typical High $1,659.59 | Facility | None | $323.59 | $870.96 | $1,659.59 |
Cigna Setting Professional Modifier None Typical Low $54.95 Median $112.20 Typical High $245.47 | Professional | None | $54.95 | $112.20 | $245.47 |
Florida Blue Setting Facility Modifier None Typical Low $213.80 Median $457.09 Typical High $6,309.57 | Facility | None | $213.80 | $457.09 | $6,309.57 |
Florida Blue Setting Professional Modifier None Typical Low $97.72 Median $123.03 Typical High $154.88 | Professional | None | $97.72 | $123.03 | $154.88 |
Molina Setting Professional Modifier None Typical Low $97.72 Median $141.25 Typical High $281.84 | Professional | None | $97.72 | $141.25 | $281.84 |
United Setting Facility Modifier None Typical Low $398.11 Median $1,000.00 Typical High $5,623.41 | Facility | None | $398.11 | $1,000.00 | $5,623.41 |
United Setting Professional Modifier None Typical Low $57.54 Median $123.03 Typical High $257.04 | Professional | None | $57.54 | $123.03 | $257.04 |
Wellpoint Setting Professional Modifier None Typical Low $47.86 Median $123.03 Typical High $123.03 | Professional | None | $47.86 | $123.03 | $123.03 |
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 $29.51 Median $54.95 Typical High $67.61 | Professional | 52 · Reduced service | $29.51 | $54.95 | $67.61 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $12.02 Median $21.88 Typical High $26.92 | Professional | 53 · Discontinued | $12.02 | $21.88 | $26.92 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $44.67 Median $83.18 Typical High $100.00 | Professional | 54 · Surgery only | $44.67 | $83.18 | $100.00 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $8.91 Median $16.60 Typical High $19.95 | Professional | 55 · Aftercare only | $8.91 | $16.60 | $19.95 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $5.89 Median $10.96 Typical High $13.49 | Professional | 56 · Pre-op care only | $5.89 | $10.96 | $13.49 |
Where Florida sits
The same service costs 4.9 times more in Alaska than in Hawaii. 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· 17th of 51
$182
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.