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 $2,951.21 Typical High $10,964.78 | Facility | None | $407.38 | $2,951.21 | $10,964.78 |
Aetna Setting Professional Modifier None Typical Low $131.83 Median $478.63 Typical High $851.14 | Professional | None | $131.83 | $478.63 | $851.14 |
Ambetter Setting Professional Modifier None Typical Low $144.54 Median $165.96 Typical High $660.69 | Professional | None | $144.54 | $165.96 | $660.69 |
AvMed Setting Facility Modifier None Typical Low $537.03 Median $1,905.46 Typical High $9,772.37 | Facility | None | $537.03 | $1,905.46 | $9,772.37 |
AvMed Setting Professional Modifier None Typical Low $162.18 Median $562.34 Typical High $741.31 | Professional | None | $162.18 | $562.34 | $741.31 |
Cigna Setting Facility Modifier None Typical Low $457.09 Median $660.69 Typical High $1,148.15 | Facility | None | $457.09 | $660.69 | $1,148.15 |
Cigna Setting Professional Modifier None Typical Low $125.89 Median $467.74 Typical High $933.25 | Professional | None | $125.89 | $467.74 | $933.25 |
Florida Blue Setting Facility Modifier None Typical Low $363.08 Median $776.25 Typical High $6,309.57 | Facility | None | $363.08 | $776.25 | $6,309.57 |
Florida Blue Setting Professional Modifier None Typical Low $346.74 Median $562.34 Typical High $691.83 | Professional | None | $346.74 | $562.34 | $691.83 |
Molina Setting Professional Modifier None Typical Low $199.53 Median $575.44 Typical High $1,380.38 | Professional | None | $199.53 | $575.44 | $1,380.38 |
United Setting Facility Modifier None Typical Low $398.11 Median $1,000.00 Typical High $5,623.41 | Facility | None | $398.11 | $1,000.00 | $5,623.41 |
United Setting Professional Modifier None Typical Low $144.54 Median $457.09 Typical High $1,047.13 | Professional | None | $144.54 | $457.09 | $1,047.13 |
Wellpoint Setting Professional Modifier None Typical Low $114.82 Median $537.03 Typical High $537.03 | Professional | None | $114.82 | $537.03 | $537.03 |
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 $66.07 Median $208.93 Typical High $371.54 | Professional | 52 · Reduced service | $66.07 | $208.93 | $371.54 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $26.30 Median $83.18 Typical High $147.91 | Professional | 53 · Discontinued | $26.30 | $83.18 | $147.91 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $100.00 Median $309.03 Typical High $549.54 | Professional | 54 · Surgery only | $100.00 | $309.03 | $549.54 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $19.95 Median $61.66 Typical High $112.20 | Professional | 55 · Aftercare only | $19.95 | $61.66 | $112.20 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $13.18 Median $47.86 Typical High $74.13 | Professional | 56 · Pre-op care only | $13.18 | $47.86 | $74.13 |
Ambetter Setting Professional Modifier Q6 · Substitute physician, paid per time Typical Low $144.54 Median $144.54 Typical High $144.54 | Professional | Q6 · Substitute physician, paid per time | $144.54 | $144.54 | $144.54 |
Where Florida sits
The same service costs 5.2 times more in Wisconsin 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· 42nd of 51
$525
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.