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 $524.81 Median $3,019.95 Typical High $10,964.78 | Facility | None | $524.81 | $3,019.95 | $10,964.78 |
Aetna Setting Professional Modifier None Typical Low $295.12 Median $1,380.38 Typical High $2,398.83 | Professional | None | $295.12 | $1,380.38 | $2,398.83 |
Ambetter Setting Professional Modifier None Typical Low $194.98 Median $295.12 Typical High $588.84 | Professional | None | $194.98 | $295.12 | $588.84 |
AvMed Setting Facility Modifier None Typical Low $1,445.44 Median $6,025.60 Typical High $13,182.57 | Facility | None | $1,445.44 | $6,025.60 | $13,182.57 |
AvMed Setting Professional Modifier None Typical Low $346.74 Median $1,621.81 Typical High $2,137.96 | Professional | None | $346.74 | $1,621.81 | $2,137.96 |
Cigna Setting Facility Modifier None Typical Low $537.03 Median $537.03 Typical High $537.03 | Facility | None | $537.03 | $537.03 | $537.03 |
Cigna Setting Professional Modifier None Typical Low $257.04 Median $1,122.02 Typical High $2,818.38 | Professional | None | $257.04 | $1,122.02 | $2,818.38 |
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 $354.81 Median $1,122.02 Typical High $2,238.72 | Professional | None | $354.81 | $1,122.02 | $2,238.72 |
Molina Setting Professional Modifier None Typical Low $645.65 Median $1,659.59 Typical High $3,981.07 | Professional | None | $645.65 | $1,659.59 | $3,981.07 |
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 $281.84 Median $1,071.52 Typical High $3,019.95 | Professional | None | $281.84 | $1,071.52 | $3,019.95 |
Wellpoint Setting Professional Modifier None Typical Low $234.42 Median $1,513.56 Typical High $1,513.56 | Professional | None | $234.42 | $1,513.56 | $1,513.56 |
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 $147.91 Median $691.83 Typical High $1,071.52 | Professional | 52 · Reduced service | $147.91 | $691.83 | $1,071.52 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $58.88 Median $275.42 Typical High $426.58 | Professional | 53 · Discontinued | $58.88 | $275.42 | $426.58 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $223.87 Median $1,023.29 Typical High $1,584.89 | Professional | 54 · Surgery only | $223.87 | $1,023.29 | $1,584.89 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $44.67 Median $204.17 Typical High $323.59 | Professional | 55 · Aftercare only | $44.67 | $204.17 | $323.59 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $29.51 Median $138.04 Typical High $213.80 | Professional | 56 · Pre-op care only | $29.51 | $138.04 | $213.80 |
Where Florida sits
The same service costs 5.5 times more in Washington than in Kentucky. 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· 28th of 51
$1,514
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.