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 $3,311.31 Typical High $11,481.54 | Facility | None | $407.38 | $3,311.31 | $11,481.54 |
Aetna Setting Professional Modifier None Typical Low $100.00 Median $107.15 Typical High $158.49 | Professional | None | $100.00 | $107.15 | $158.49 |
AvMed Setting Facility Modifier None Typical Low $331.13 Median $1,513.56 Typical High $9,772.37 | Facility | None | $331.13 | $1,513.56 | $9,772.37 |
AvMed Setting Professional Modifier None Typical Low $83.18 Median $109.65 Typical High $141.25 | Professional | None | $83.18 | $109.65 | $141.25 |
Cigna Setting Facility Modifier None Typical Low $331.13 Median $2,041.74 Typical High $17,378.01 | Facility | None | $331.13 | $2,041.74 | $17,378.01 |
Cigna Setting Professional Modifier None Typical Low $81.28 Median $125.89 Typical High $234.42 | Professional | None | $81.28 | $125.89 | $234.42 |
Florida Blue Setting Facility Modifier None Typical Low $1,258.93 Median $2,691.53 Typical High $11,748.98 | Facility | None | $1,258.93 | $2,691.53 | $11,748.98 |
Florida Blue Setting Professional Modifier None Typical Low $70.79 Median $74.13 Typical High $138.04 | Professional | None | $70.79 | $74.13 | $138.04 |
Molina Setting Professional Modifier None Typical Low $79.43 Median $107.15 Typical High $151.36 | Professional | None | $79.43 | $107.15 | $151.36 |
United Setting Facility Modifier None Typical Low $954.99 Median $2,344.23 Typical High $11,220.18 | Facility | None | $954.99 | $2,344.23 | $11,220.18 |
United Setting Professional Modifier None Typical Low $54.95 Median $131.83 Typical High $295.12 | Professional | None | $54.95 | $131.83 | $295.12 |
Wellpoint Setting Professional Modifier None Typical Low $79.43 Median $79.43 Typical High $104.71 | Professional | None | $79.43 | $79.43 | $104.71 |
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 $50.12 Median $53.70 Typical High $69.18 | Professional | 52 · Reduced service | $50.12 | $53.70 | $69.18 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $19.95 Median $21.38 Typical High $27.54 | Professional | 53 · Discontinued | $19.95 | $21.38 | $27.54 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $74.13 Median $81.28 Typical High $102.33 | Professional | 54 · Surgery only | $74.13 | $81.28 | $102.33 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $14.79 Median $16.22 Typical High $20.42 | Professional | 55 · Aftercare only | $14.79 | $16.22 | $20.42 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $10.00 Median $10.72 Typical High $13.80 | Professional | 56 · Pre-op care only | $10.00 | $10.72 | $13.80 |
Where Florida sits
The same service costs 12.9 times more in Arkansas than in New York. 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· 4th of 51
$1,380
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.