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 $354.81 Median $3,019.95 Typical High $10,964.78 | Facility | None | $354.81 | $3,019.95 | $10,964.78 |
Aetna Setting Professional Modifier None Typical Low $91.20 Median $158.49 Typical High $316.23 | Professional | None | $91.20 | $158.49 | $316.23 |
Ambetter Setting Professional Modifier None Typical Low $141.25 Median $141.25 Typical High $158.49 | Professional | None | $141.25 | $141.25 | $158.49 |
AvMed Setting Facility Modifier None Typical Low $229.09 Median $1,479.11 Typical High $9,772.37 | Facility | None | $229.09 | $1,479.11 | $9,772.37 |
AvMed Setting Professional Modifier None Typical Low $87.10 Median $173.78 Typical High $281.84 | Professional | None | $87.10 | $173.78 | $281.84 |
Cigna Setting Facility Modifier None Typical Low $331.13 Median $1,905.46 Typical High $17,378.01 | Facility | None | $331.13 | $1,905.46 | $17,378.01 |
Cigna Setting Professional Modifier None Typical Low $61.66 Median $144.54 Typical High $331.13 | Professional | None | $61.66 | $144.54 | $331.13 |
Florida Blue Setting Facility Modifier None Typical Low $524.81 Median $1,071.52 Typical High $11,748.98 | Facility | None | $524.81 | $1,071.52 | $11,748.98 |
Florida Blue Setting Professional Modifier None Typical Low $147.91 Median $154.88 Typical High $346.74 | Professional | None | $147.91 | $154.88 | $346.74 |
Molina Setting Professional Modifier None Typical Low $102.33 Median $204.17 Typical High $288.40 | Professional | None | $102.33 | $204.17 | $288.40 |
United Setting Facility Modifier None Typical Low $281.84 Median $660.69 Typical High $4,897.79 | Facility | None | $281.84 | $660.69 | $4,897.79 |
United Setting Professional Modifier None Typical Low $64.57 Median $173.78 Typical High $436.52 | Professional | None | $64.57 | $173.78 | $436.52 |
Wellpoint Setting Professional Modifier None Typical Low $61.66 Median $154.88 Typical High $154.88 | Professional | None | $61.66 | $154.88 | $154.88 |
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 $41.69 Median $74.13 Typical High $107.15 | Professional | 52 · Reduced service | $41.69 | $74.13 | $107.15 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $16.60 Median $29.51 Typical High $42.66 | Professional | 53 · Discontinued | $16.60 | $29.51 | $42.66 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $63.10 Median $112.20 Typical High $158.49 | Professional | 54 · Surgery only | $63.10 | $112.20 | $158.49 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $12.59 Median $22.39 Typical High $31.62 | Professional | 55 · Aftercare only | $12.59 | $22.39 | $31.62 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $8.32 Median $14.79 Typical High $21.38 | Professional | 56 · Pre-op care only | $8.32 | $14.79 | $21.38 |
Where Florida sits
The same service costs 4.1 times more in Alaska 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· 5th of 51
$380
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.