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 $645.65 Median $5,011.87 Typical High $11,481.54 | Facility | None | $645.65 | $5,011.87 | $11,481.54 |
Aetna Setting Professional Modifier None Typical Low $436.52 Median $457.09 Typical High $588.84 | Professional | None | $436.52 | $457.09 | $588.84 |
AvMed Setting Facility Modifier None Typical Low $446.68 Median $4,365.16 Typical High $13,182.57 | Facility | None | $446.68 | $4,365.16 | $13,182.57 |
AvMed Setting Professional Modifier None Typical Low $407.38 Median $512.86 Typical High $588.84 | Professional | None | $407.38 | $512.86 | $588.84 |
Cigna Setting Facility Modifier None Typical Low $501.19 Median $4,786.30 Typical High $9,120.11 | Facility | None | $501.19 | $4,786.30 | $9,120.11 |
Cigna Setting Professional Modifier None Typical Low $354.81 Median $501.19 Typical High $1,023.29 | Professional | None | $354.81 | $501.19 | $1,023.29 |
Florida Blue Setting Facility Modifier None Typical Low $1,318.26 Median $2,818.38 Typical High $16,982.44 | Facility | None | $1,318.26 | $2,818.38 | $16,982.44 |
Florida Blue Setting Professional Modifier None Typical Low $331.13 Median $354.81 Typical High $602.56 | Professional | None | $331.13 | $354.81 | $602.56 |
Molina Setting Professional Modifier None Typical Low $398.11 Median $537.03 Typical High $1,000.00 | Professional | None | $398.11 | $537.03 | $1,000.00 |
United Setting Facility Modifier None Typical Low $1,230.27 Median $3,311.31 Typical High $12,589.25 | Facility | None | $1,230.27 | $3,311.31 | $12,589.25 |
United Setting Professional Modifier None Typical Low $60.26 Median $549.54 Typical High $1,047.13 | Professional | None | $60.26 | $549.54 | $1,047.13 |
Wellpoint Setting Professional Modifier None Typical Low $346.74 Median $346.74 Typical High $478.63 | Professional | None | $346.74 | $346.74 | $478.63 |
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 $218.78 Median $229.09 Typical High $275.42 | Professional | 52 · Reduced service | $218.78 | $229.09 | $275.42 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $87.10 Median $91.20 Typical High $109.65 | Professional | 53 · Discontinued | $87.10 | $91.20 | $109.65 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $331.13 Median $338.84 Typical High $416.87 | Professional | 54 · Surgery only | $331.13 | $338.84 | $416.87 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $66.07 Median $67.61 Typical High $83.18 | Professional | 55 · Aftercare only | $66.07 | $67.61 | $83.18 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $43.65 Median $45.71 Typical High $54.95 | Professional | 56 · Pre-op care only | $43.65 | $45.71 | $54.95 |
Where Florida sits
The same service costs 3.9 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· 9th of 51
$1,023
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.