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 $602.56 Median $3,801.89 Typical High $10,964.78 | Facility | None | $602.56 | $3,801.89 | $10,964.78 |
Aetna Setting Professional Modifier None Typical Low $186.21 Median $794.33 Typical High $1,258.93 | Professional | None | $186.21 | $794.33 | $1,258.93 |
Ambetter Setting Professional Modifier None Typical Low $173.78 Median $173.78 Typical High $173.78 | Professional | None | $173.78 | $173.78 | $173.78 |
AvMed Setting Facility Modifier None Typical Low $891.25 Median $5,128.61 Typical High $13,182.57 | Facility | None | $891.25 | $5,128.61 | $13,182.57 |
AvMed Setting Professional Modifier None Typical Low $204.17 Median $794.33 Typical High $1,047.13 | Professional | None | $204.17 | $794.33 | $1,047.13 |
Cigna Setting Facility Modifier None Typical Low $316.23 Median $316.23 Typical High $323.59 | Facility | None | $316.23 | $316.23 | $323.59 |
Cigna Setting Professional Modifier None Typical Low $154.88 Median $676.08 Typical High $1,584.89 | Professional | None | $154.88 | $676.08 | $1,584.89 |
Florida Blue Setting Facility Modifier None Typical Low $4,466.84 Median $8,912.51 Typical High $16,595.87 | Facility | None | $4,466.84 | $8,912.51 | $16,595.87 |
Florida Blue Setting Professional Modifier None Typical Low $660.69 Median $1,096.48 Typical High $1,348.96 | Professional | None | $660.69 | $1,096.48 | $1,348.96 |
Molina Setting Professional Modifier None Typical Low $380.19 Median $812.83 Typical High $1,949.84 | Professional | None | $380.19 | $812.83 | $1,949.84 |
United Setting Facility Modifier None Typical Low $1,659.59 Median $8,128.31 Typical High $13,182.57 | Facility | None | $1,659.59 | $8,128.31 | $13,182.57 |
United Setting Professional Modifier None Typical Low $186.21 Median $758.58 Typical High $1,778.28 | Professional | None | $186.21 | $758.58 | $1,778.28 |
Wellpoint Setting Professional Modifier None Typical Low $138.04 Median $741.31 Typical High $741.31 | Professional | None | $138.04 | $741.31 | $741.31 |
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 $93.33 Median $398.11 Typical High $588.84 | Professional | 52 · Reduced service | $93.33 | $398.11 | $588.84 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $37.15 Median $158.49 Typical High $239.88 | Professional | 53 · Discontinued | $37.15 | $158.49 | $239.88 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $141.25 Median $588.84 Typical High $891.25 | Professional | 54 · Surgery only | $141.25 | $588.84 | $891.25 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $28.18 Median $117.49 Typical High $177.83 | Professional | 55 · Aftercare only | $28.18 | $117.49 | $177.83 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $18.62 Median $79.43 Typical High $120.23 | Professional | 56 · Pre-op care only | $18.62 | $79.43 | $120.23 |
Where Florida sits
The same service costs 5.9 times more in Wisconsin than in Maryland. 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
$759
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.