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 $501.19 Median $3,019.95 Typical High $10,964.78 | Facility | None | $501.19 | $3,019.95 | $10,964.78 |
Aetna Setting Professional Modifier None Typical Low $218.78 Median $977.24 Typical High $1,584.89 | Professional | None | $218.78 | $977.24 | $1,584.89 |
Ambetter Setting Professional Modifier None Typical Low $102.33 Median $1,096.48 Typical High $1,096.48 | Professional | None | $102.33 | $1,096.48 | $1,096.48 |
AvMed Setting Facility Modifier None Typical Low $977.24 Median $6,025.60 Typical High $13,182.57 | Facility | None | $977.24 | $6,025.60 | $13,182.57 |
AvMed Setting Professional Modifier None Typical Low $229.09 Median $977.24 Typical High $1,318.26 | Professional | None | $229.09 | $977.24 | $1,318.26 |
Cigna Setting Facility Modifier None Typical Low $371.54 Median $371.54 Typical High $371.54 | Facility | None | $371.54 | $371.54 | $371.54 |
Cigna Setting Professional Modifier None Typical Low $177.83 Median $776.25 Typical High $1,949.84 | Professional | None | $177.83 | $776.25 | $1,949.84 |
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 $269.15 Median $676.08 Typical High $1,348.96 | Professional | None | $269.15 | $676.08 | $1,348.96 |
Molina Setting Professional Modifier None Typical Low $446.68 Median $1,023.29 Typical High $2,511.89 | Professional | None | $446.68 | $1,023.29 | $2,511.89 |
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 $204.17 Median $776.25 Typical High $2,041.74 | Professional | None | $204.17 | $776.25 | $2,041.74 |
Wellpoint Setting Professional Modifier None Typical Low $162.18 Median $933.25 Typical High $933.25 | Professional | None | $162.18 | $933.25 | $933.25 |
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 $109.65 Median $489.78 Typical High $741.31 | Professional | 52 · Reduced service | $109.65 | $489.78 | $741.31 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $43.65 Median $194.98 Typical High $295.12 | Professional | 53 · Discontinued | $43.65 | $194.98 | $295.12 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $165.96 Median $724.44 Typical High $1,096.48 | Professional | 54 · Surgery only | $165.96 | $724.44 | $1,096.48 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $33.11 Median $147.91 Typical High $223.87 | Professional | 55 · Aftercare only | $33.11 | $147.91 | $223.87 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $21.88 Median $97.72 Typical High $147.91 | Professional | 56 · Pre-op care only | $21.88 | $97.72 | $147.91 |
Ambetter Setting Professional Modifier 50 · Both sides Typical Low $323.59 Median $323.59 Typical High $575.44 | Professional | 50 · Both sides | $323.59 | $323.59 | $575.44 |
Where Florida sits
The same service costs 5.8 times more in Washington than in Hawaii. 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
$933
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.