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 $776.25 Median $5,495.41 Typical High $15,135.61 | Facility | None | $776.25 | $5,495.41 | $15,135.61 |
Aetna Setting Professional Modifier None Typical Low $380.19 Median $575.44 Typical High $660.69 | Professional | None | $380.19 | $575.44 | $660.69 |
AvMed Setting Facility Modifier None Typical Low $371.54 Median $2,137.96 Typical High $12,882.50 | Facility | None | $371.54 | $2,137.96 | $12,882.50 |
AvMed Setting Professional Modifier None Typical Low $331.13 Median $457.09 Typical High $758.58 | Professional | None | $331.13 | $457.09 | $758.58 |
Cigna Setting Facility Modifier None Typical Low $457.09 Median $2,137.96 Typical High $2,754.23 | Facility | None | $457.09 | $2,137.96 | $2,754.23 |
Cigna Setting Professional Modifier None Typical Low $288.40 Median $512.86 Typical High $1,148.15 | Professional | None | $288.40 | $512.86 | $1,148.15 |
Florida Blue Setting Facility Modifier None Typical Low $10,471.29 Median $22,387.21 Typical High $33,884.42 | Facility | None | $10,471.29 | $22,387.21 | $33,884.42 |
Florida Blue Setting Professional Modifier None Typical Low $269.15 Median $288.40 Typical High $691.83 | Professional | None | $269.15 | $288.40 | $691.83 |
Molina Setting Professional Modifier None Typical Low $302.00 Median $416.87 Typical High $588.84 | Professional | None | $302.00 | $416.87 | $588.84 |
United Setting Facility Modifier None Typical Low $371.54 Median $954.99 Typical High $7,585.78 | Facility | None | $371.54 | $954.99 | $7,585.78 |
United Setting Professional Modifier None Typical Low $54.95 Median $575.44 Typical High $1,348.96 | Professional | None | $54.95 | $575.44 | $1,348.96 |
Wellpoint Setting Professional Modifier None Typical Low $275.42 Median $275.42 Typical High $407.38 | Professional | None | $275.42 | $275.42 | $407.38 |
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 $190.55 Median $288.40 Typical High $288.40 | Professional | 52 · Reduced service | $190.55 | $288.40 | $288.40 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $75.86 Median $114.82 Typical High $114.82 | Professional | 53 · Discontinued | $75.86 | $114.82 | $114.82 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $281.84 Median $426.58 Typical High $436.52 | Professional | 54 · Surgery only | $281.84 | $426.58 | $436.52 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $56.23 Median $85.11 Typical High $87.10 | Professional | 55 · Aftercare only | $56.23 | $85.11 | $87.10 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $38.02 Median $57.54 Typical High $57.54 | Professional | 56 · Pre-op care only | $38.02 | $57.54 | $57.54 |
Where Florida sits
The same service costs 3.7 times more in Wisconsin 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· 41st of 51
$631
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.