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 $275.42 Median $2,884.03 Typical High $10,964.78 | Facility | None | $275.42 | $2,884.03 | $10,964.78 |
Aetna Setting Professional Modifier None Typical Low $43.65 Median $173.78 Typical High $380.19 | Professional | None | $43.65 | $173.78 | $380.19 |
Ambetter Setting Professional Modifier None Typical Low $20.42 Median $40.74 Typical High $40.74 | Professional | None | $20.42 | $40.74 | $40.74 |
AvMed Setting Facility Modifier None Typical Low $208.93 Median $6,025.60 Typical High $13,182.57 | Facility | None | $208.93 | $6,025.60 | $13,182.57 |
AvMed Setting Professional Modifier None Typical Low $45.71 Median $199.53 Typical High $346.74 | Professional | None | $45.71 | $199.53 | $346.74 |
Cigna Setting Facility Modifier None Typical Low $74.13 Median $74.13 Typical High $74.13 | Facility | None | $74.13 | $74.13 | $74.13 |
Cigna Setting Professional Modifier None Typical Low $36.31 Median $173.78 Typical High $436.52 | Professional | None | $36.31 | $173.78 | $436.52 |
Florida Blue Setting Facility Modifier None Typical Low $58.88 Median $302.00 Typical High $302.00 | Facility | None | $58.88 | $302.00 | $302.00 |
Florida Blue Setting Professional Modifier None Typical Low $165.96 Median $354.81 Typical High $478.63 | Professional | None | $165.96 | $354.81 | $478.63 |
Molina Setting Professional Modifier None Typical Low $69.18 Median $190.55 Typical High $467.74 | Professional | None | $69.18 | $190.55 | $467.74 |
United Setting Facility Modifier None Typical Low $169.82 Median $1,819.70 Typical High $5,248.07 | Facility | None | $169.82 | $1,819.70 | $5,248.07 |
United Setting Professional Modifier None Typical Low $41.69 Median $190.55 Typical High $478.63 | Professional | None | $41.69 | $190.55 | $478.63 |
Wellpoint Setting Professional Modifier None Typical Low $32.36 Median $85.11 Typical High $85.11 | Professional | None | $32.36 | $85.11 | $85.11 |
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 $21.88 Median $114.82 Typical High $169.82 | Professional | 52 · Reduced service | $21.88 | $114.82 | $169.82 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $8.71 Median $45.71 Typical High $67.61 | Professional | 53 · Discontinued | $8.71 | $45.71 | $67.61 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $33.11 Median $173.78 Typical High $251.19 | Professional | 54 · Surgery only | $33.11 | $173.78 | $251.19 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $6.61 Median $34.67 Typical High $50.12 | Professional | 55 · Aftercare only | $6.61 | $34.67 | $50.12 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $4.37 Median $22.91 Typical High $33.88 | Professional | 56 · Pre-op care only | $4.37 | $22.91 | $33.88 |
Ambetter Setting Professional Modifier 50 · Both sides Typical Low $66.07 Median $66.07 Typical High $66.07 | Professional | 50 · Both sides | $66.07 | $66.07 | $66.07 |
Where Florida sits
The same service costs 4.9 times more in Iowa 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· 43rd of 51
$182
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.