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 $15.49 Median $21.88 Typical High $588.84 | Facility | None | $15.49 | $21.88 | $588.84 |
Aetna Setting Professional Modifier None Typical Low $15.49 Median $22.39 Typical High $32.36 | Professional | None | $15.49 | $22.39 | $32.36 |
Ambetter Setting Professional Modifier None Typical Low $26.30 Median $27.54 Typical High $35.48 | Professional | None | $26.30 | $27.54 | $35.48 |
AvMed Setting Facility Modifier None Typical Low $16.98 Median $2,137.96 Typical High $11,748.98 | Facility | None | $16.98 | $2,137.96 | $11,748.98 |
AvMed Setting Professional Modifier None Typical Low $16.22 Median $28.18 Typical High $38.90 | Professional | None | $16.22 | $28.18 | $38.90 |
Cigna Setting Facility Modifier None Typical Low $14.13 Median $23.99 Typical High $66.07 | Facility | None | $14.13 | $23.99 | $66.07 |
Cigna Setting Professional Modifier None Typical Low $12.59 Median $19.95 Typical High $38.02 | Professional | None | $12.59 | $19.95 | $38.02 |
Florida Blue Setting Facility Modifier None Typical Low $34.67 Median $70.79 Typical High $2,137.96 | Facility | None | $34.67 | $70.79 | $2,137.96 |
Florida Blue Setting Professional Modifier None Typical Low $15.85 Median $26.92 Typical High $39.81 | Professional | None | $15.85 | $26.92 | $39.81 |
Molina Setting Professional Modifier None Typical Low $12.59 Median $14.79 Typical High $22.91 | Professional | None | $12.59 | $14.79 | $22.91 |
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 $13.18 Median $22.91 Typical High $45.71 | Professional | None | $13.18 | $22.91 | $45.71 |
Wellpoint Setting Professional Modifier None Typical Low $12.02 Median $21.88 Typical High $21.88 | Professional | None | $12.02 | $21.88 | $21.88 |
6 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 $7.76 Median $10.96 Typical High $16.22 | Professional | 52 · Reduced service | $7.76 | $10.96 | $16.22 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $3.16 Median $4.47 Typical High $6.46 | Professional | 53 · Discontinued | $3.16 | $4.47 | $6.46 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $2.34 Median $3.31 Typical High $4.79 | Professional | 55 · Aftercare only | $2.34 | $3.31 | $4.79 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $1.55 Median $2.19 Typical High $3.24 | Professional | 56 · Pre-op care only | $1.55 | $2.19 | $3.24 |
Ambetter Setting Professional Modifier 50 · Both sides Typical Low $39.81 Median $39.81 Typical High $42.66 | Professional | 50 · Both sides | $39.81 | $39.81 | $42.66 |
Ambetter Setting Professional Modifier 59 · Distinct service Typical Low $26.30 Median $26.30 Typical High $26.30 | Professional | 59 · Distinct service | $26.30 | $26.30 | $26.30 |
Where Florida sits
The same service costs 3.0 times more in Alaska than in Virginia. 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
$22.91
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.