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 $407.38 Median $2,884.03 Typical High $10,964.78 | Facility | None | $407.38 | $2,884.03 | $10,964.78 |
Aetna Setting Professional Modifier None Typical Low $208.93 Median $912.01 Typical High $1,584.89 | Professional | None | $208.93 | $912.01 | $1,584.89 |
Ambetter Setting Professional Modifier None Typical Low $229.09 Median $229.09 Typical High $323.59 | Professional | None | $229.09 | $229.09 | $323.59 |
AvMed Setting Facility Modifier None Typical Low $1,202.26 Median $6,025.60 Typical High $13,182.57 | Facility | None | $1,202.26 | $6,025.60 | $13,182.57 |
AvMed Setting Professional Modifier None Typical Low $263.03 Median $1,230.27 Typical High $1,659.59 | Professional | None | $263.03 | $1,230.27 | $1,659.59 |
Cigna Setting Facility Modifier None Typical Low $323.59 Median $323.59 Typical High $398.11 | Facility | None | $323.59 | $323.59 | $398.11 |
Cigna Setting Professional Modifier None Typical Low $194.98 Median $870.96 Typical High $1,949.84 | Professional | None | $194.98 | $870.96 | $1,949.84 |
Florida Blue Setting Facility Modifier None Typical Low $1,348.96 Median $2,754.23 Typical High $6,309.57 | Facility | None | $1,348.96 | $2,754.23 | $6,309.57 |
Florida Blue Setting Professional Modifier None Typical Low $707.95 Median $1,174.90 Typical High $1,445.44 | Professional | None | $707.95 | $1,174.90 | $1,445.44 |
Molina Setting Professional Modifier None Typical Low $489.78 Median $1,258.93 Typical High $3,090.30 | Professional | None | $489.78 | $1,258.93 | $3,090.30 |
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 $218.78 Median $912.01 Typical High $2,041.74 | Professional | None | $218.78 | $912.01 | $2,041.74 |
Wellpoint Setting Professional Modifier None Typical Low $173.78 Median $1,096.48 Typical High $1,096.48 | Professional | None | $173.78 | $1,096.48 | $1,096.48 |
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 $100.00 Median $457.09 Typical High $741.31 | Professional | 52 · Reduced service | $100.00 | $457.09 | $741.31 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $39.81 Median $181.97 Typical High $295.12 | Professional | 53 · Discontinued | $39.81 | $181.97 | $295.12 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $147.91 Median $691.83 Typical High $1,096.48 | Professional | 54 · Surgery only | $147.91 | $691.83 | $1,096.48 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $29.51 Median $138.04 Typical High $218.78 | Professional | 55 · Aftercare only | $29.51 | $138.04 | $218.78 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $19.95 Median $91.20 Typical High $147.91 | Professional | 56 · Pre-op care only | $19.95 | $91.20 | $147.91 |
Where Florida sits
The same service costs 6.5 times more in Washington 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· 33rd of 51
$1,096
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.