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 $3,890.45 Typical High $12,022.64 | Facility | None | $776.25 | $3,890.45 | $12,022.64 |
Aetna Setting Professional Modifier None Typical Low $977.24 Median $1,318.26 Typical High $1,819.70 | Professional | None | $977.24 | $1,318.26 | $1,819.70 |
AvMed Setting Facility Modifier None Typical Low $1,348.96 Median $4,365.16 Typical High $13,182.57 | Facility | None | $1,348.96 | $4,365.16 | $13,182.57 |
AvMed Setting Professional Modifier None Typical Low $1,621.81 Median $1,949.84 Typical High $2,454.71 | Professional | None | $1,621.81 | $1,949.84 | $2,454.71 |
Cigna Setting Facility Modifier None Typical Low $398.11 Median $501.19 Typical High $2,691.53 | Facility | None | $398.11 | $501.19 | $2,691.53 |
Cigna Setting Professional Modifier None Typical Low $1,096.48 Median $1,445.44 Typical High $2,951.21 | Professional | None | $1,096.48 | $1,445.44 | $2,951.21 |
Florida Blue Setting Facility Modifier None Typical Low $10,000.00 Median $21,877.62 Typical High $33,884.42 | Facility | None | $10,000.00 | $21,877.62 | $33,884.42 |
Florida Blue Setting Professional Modifier None Typical Low $1,548.82 Median $2,454.71 Typical High $2,454.71 | Professional | None | $1,548.82 | $2,454.71 | $2,454.71 |
Molina Setting Professional Modifier None Typical Low $50.12 Median $50.12 Typical High $50.12 | Professional | None | $50.12 | $50.12 | $50.12 |
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 $1,230.27 Median $1,949.84 Typical High $3,801.89 | Professional | None | $1,230.27 | $1,949.84 | $3,801.89 |
Wellpoint Setting Professional Modifier None Typical Low $1,659.59 Median $1,659.59 Typical High $1,659.59 | Professional | None | $1,659.59 | $1,659.59 | $1,659.59 |
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 $489.78 Median $660.69 Typical High $870.96 | Professional | 52 · Reduced service | $489.78 | $660.69 | $870.96 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $194.98 Median $263.03 Typical High $346.74 | Professional | 53 · Discontinued | $194.98 | $263.03 | $346.74 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $724.44 Median $1,000.00 Typical High $1,318.26 | Professional | 54 · Surgery only | $724.44 | $1,000.00 | $1,318.26 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $144.54 Median $199.53 Typical High $263.03 | Professional | 55 · Aftercare only | $144.54 | $199.53 | $263.03 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $97.72 Median $131.83 Typical High $173.78 | Professional | 56 · Pre-op care only | $97.72 | $131.83 | $173.78 |
Where Florida sits
The same service costs 4.7 times more in Alaska than in Arkansas. 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· 37th of 51
$1,778
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.