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 $128.82 Typical High $208.93 | Professional | None | $58.88 | $128.82 | $208.93 |
Ambetter Setting Professional Modifier None Typical Low $50.12 Median $56.23 Typical High $162.18 | Professional | None | $50.12 | $56.23 | $162.18 |
AvMed Setting Facility Modifier None Typical Low $158.49 Median $6,025.60 Typical High $13,182.57 | Facility | None | $158.49 | $6,025.60 | $13,182.57 |
AvMed Setting Professional Modifier None Typical Low $60.26 Median $154.88 Typical High $199.53 | Professional | None | $60.26 | $154.88 | $199.53 |
Cigna Setting Facility Modifier None Typical Low $398.11 Median $398.11 Typical High $407.38 | Facility | None | $398.11 | $398.11 | $407.38 |
Cigna Setting Professional Modifier None Typical Low $48.98 Median $131.83 Typical High $295.12 | Professional | None | $48.98 | $131.83 | $295.12 |
Florida Blue Setting Facility Modifier None Typical Low $58.88 Median $177.83 Typical High $177.83 | Facility | None | $58.88 | $177.83 | $177.83 |
Florida Blue Setting Professional Modifier None Typical Low $125.89 Median $208.93 Typical High $354.81 | Professional | None | $125.89 | $208.93 | $354.81 |
Molina Setting Professional Modifier None Typical Low $91.20 Median $134.90 Typical High $338.84 | Professional | None | $91.20 | $134.90 | $338.84 |
United Setting Facility Modifier None Typical Low $169.82 Median $1,819.70 Typical High $5,248.07 | Facility | None | $169.82 | $1,819.70 | $5,248.07 |
United Setting Professional Modifier None Typical Low $56.23 Median $134.90 Typical High $288.40 | Professional | None | $56.23 | $134.90 | $288.40 |
Wellpoint Setting Professional Modifier None Typical Low $45.71 Median $144.54 Typical High $144.54 | Professional | None | $45.71 | $144.54 | $144.54 |
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 $28.84 Median $63.10 Typical High $93.33 | Professional | 52 · Reduced service | $28.84 | $63.10 | $93.33 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $11.75 Median $25.12 Typical High $37.15 | Professional | 53 · Discontinued | $11.75 | $25.12 | $37.15 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $43.65 Median $95.50 Typical High $138.04 | Professional | 54 · Surgery only | $43.65 | $95.50 | $138.04 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $8.71 Median $19.05 Typical High $27.54 | Professional | 55 · Aftercare only | $8.71 | $19.05 | $27.54 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $5.89 Median $12.59 Typical High $18.62 | Professional | 56 · Pre-op care only | $5.89 | $12.59 | $18.62 |
Where Florida sits
The same service costs 3.5 times more in North Carolina than in Indiana. 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· 40th of 51
$135
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.