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 $7.94 Median $20.89 Typical High $588.84 | Facility | None | $7.94 | $20.89 | $588.84 |
Aetna Setting Professional Modifier None Typical Low $8.32 Median $19.95 Typical High $36.31 | Professional | None | $8.32 | $19.95 | $36.31 |
AvMed Setting Facility Modifier None Typical Low $28.18 Median $2,137.96 Typical High $12,882.50 | Facility | None | $28.18 | $2,137.96 | $12,882.50 |
AvMed Setting Professional Modifier None Typical Low $9.12 Median $25.12 Typical High $28.18 | Professional | None | $9.12 | $25.12 | $28.18 |
Cigna Setting Facility Modifier None Typical Low $602.56 Median $2,691.53 Typical High $2,691.53 | Facility | None | $602.56 | $2,691.53 | $2,691.53 |
Cigna Setting Professional Modifier None Typical Low $6.76 Median $20.89 Typical High $46.77 | Professional | None | $6.76 | $20.89 | $46.77 |
Florida Blue Setting Facility Modifier None Typical Low $32.36 Median $53.70 Typical High $97.72 | Facility | None | $32.36 | $53.70 | $97.72 |
Florida Blue Setting Professional Modifier None Typical Low $21.38 Median $22.39 Typical High $28.84 | Professional | None | $21.38 | $22.39 | $28.84 |
Molina Setting Professional Modifier None Typical Low $6.92 Median $26.92 Typical High $50.12 | Professional | None | $6.92 | $26.92 | $50.12 |
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 $8.71 Median $24.55 Typical High $54.95 | Professional | None | $8.71 | $24.55 | $54.95 |
Wellpoint Setting Professional Modifier None Typical Low $6.17 Median $24.55 Typical High $24.55 | Professional | None | $6.17 | $24.55 | $24.55 |
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 $4.17 Median $10.00 Typical High $14.79 | Professional | 52 · Reduced service | $4.17 | $10.00 | $14.79 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $1.66 Median $3.98 Typical High $5.89 | Professional | 53 · Discontinued | $1.66 | $3.98 | $5.89 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $6.17 Median $15.14 Typical High $21.88 | Professional | 54 · Surgery only | $6.17 | $15.14 | $21.88 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $1.23 Median $3.02 Typical High $4.37 | Professional | 55 · Aftercare only | $1.23 | $3.02 | $4.37 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $0.83 Median $2.00 Typical High $2.95 | Professional | 56 · Pre-op care only | $0.83 | $2.00 | $2.95 |
Ambetter Setting Professional Modifier 59 · Distinct service Typical Low $28.18 Median $28.18 Typical High $28.18 | Professional | 59 · Distinct service | $28.18 | $28.18 | $28.18 |
Where Florida sits
The same service costs 4.2 times more in Wisconsin than in Nebraska. 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· 12th of 51
$34.67
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.