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 $549.54 Median $3,090.30 Typical High $10,964.78 | Facility | None | $549.54 | $3,090.30 | $10,964.78 |
Aetna Setting Professional Modifier None Typical Low $213.80 Median $794.33 Typical High $1,380.38 | Professional | None | $213.80 | $794.33 | $1,380.38 |
Ambetter Setting Professional Modifier None Typical Low $100.00 Median $954.99 Typical High $1,023.29 | Professional | None | $100.00 | $954.99 | $1,023.29 |
AvMed Setting Facility Modifier None Typical Low $891.25 Median $6,025.60 Typical High $13,182.57 | Facility | None | $891.25 | $6,025.60 | $13,182.57 |
AvMed Setting Professional Modifier None Typical Low $204.17 Median $870.96 Typical High $1,174.90 | Professional | None | $204.17 | $870.96 | $1,174.90 |
Cigna Setting Facility Modifier None Typical Low $338.84 Median $338.84 Typical High $338.84 | Facility | None | $338.84 | $338.84 | $338.84 |
Cigna Setting Professional Modifier None Typical Low $158.49 Median $691.83 Typical High $1,621.81 | Professional | None | $158.49 | $691.83 | $1,621.81 |
Florida Blue Setting Facility Modifier None Typical Low $51.29 Median $53.70 Typical High $58.88 | Facility | None | $51.29 | $53.70 | $58.88 |
Florida Blue Setting Professional Modifier None Typical Low $257.04 Median $630.96 Typical High $1,230.27 | Professional | None | $257.04 | $630.96 | $1,230.27 |
Molina Setting Professional Modifier None Typical Low $407.38 Median $891.25 Typical High $2,137.96 | Professional | None | $407.38 | $891.25 | $2,137.96 |
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 $181.97 Median $691.83 Typical High $1,737.80 | Professional | None | $181.97 | $691.83 | $1,737.80 |
Wellpoint Setting Professional Modifier None Typical Low $147.91 Median $831.76 Typical High $831.76 | Professional | None | $147.91 | $831.76 | $831.76 |
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 $107.15 Median $398.11 Typical High $616.60 | Professional | 52 · Reduced service | $107.15 | $398.11 | $616.60 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $42.66 Median $158.49 Typical High $245.47 | Professional | 53 · Discontinued | $42.66 | $158.49 | $245.47 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $158.49 Median $602.56 Typical High $912.01 | Professional | 54 · Surgery only | $158.49 | $602.56 | $912.01 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $31.62 Median $120.23 Typical High $181.97 | Professional | 55 · Aftercare only | $31.62 | $120.23 | $181.97 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $21.38 Median $79.43 Typical High $123.03 | Professional | 56 · Pre-op care only | $21.38 | $79.43 | $123.03 |
Ambetter Setting Professional Modifier XU · Unusual separate service Typical Low $181.97 Median $181.97 Typical High $181.97 | Professional | XU · Unusual separate service | $181.97 | $181.97 | $181.97 |
Where Florida sits
The same service costs 4.1 times more in Washington 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· 33rd of 51
$832
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.