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 $42.66 Median $44.67 Typical High $812.83 | Facility | None | $42.66 | $44.67 | $812.83 |
Aetna Setting Professional Modifier None Typical Low $44.67 Median $44.67 Typical High $52.48 | Professional | None | $44.67 | $44.67 | $52.48 |
AvMed Setting Facility Modifier None Typical Low $41.69 Median $2,137.96 Typical High $11,748.98 | Facility | None | $41.69 | $2,137.96 | $11,748.98 |
AvMed Setting Professional Modifier None Typical Low $38.90 Median $40.74 Typical High $42.66 | Professional | None | $38.90 | $40.74 | $42.66 |
Cigna Setting Facility Modifier None Typical Low $302.00 Median $1,174.90 Typical High $1,659.59 | Facility | None | $302.00 | $1,174.90 | $1,659.59 |
Cigna Setting Professional Modifier None Typical Low $33.88 Median $47.86 Typical High $93.33 | Professional | None | $33.88 | $47.86 | $93.33 |
Florida Blue Setting Facility Modifier None Typical Low $123.03 Median $269.15 Typical High $3,981.07 | Facility | None | $123.03 | $269.15 | $3,981.07 |
Florida Blue Setting Professional Modifier None Typical Low $28.84 Median $30.90 Typical High $52.48 | Professional | None | $28.84 | $30.90 | $52.48 |
Molina Setting Professional Modifier None Typical Low $26.92 Median $36.31 Typical High $48.98 | Professional | None | $26.92 | $36.31 | $48.98 |
United Setting Facility Modifier None Typical Low $81.28 Median $302.00 Typical High $2,818.38 | Facility | None | $81.28 | $302.00 | $2,818.38 |
United Setting Professional Modifier None Typical Low $38.02 Median $54.95 Typical High $102.33 | Professional | None | $38.02 | $54.95 | $102.33 |
Wellpoint Setting Professional Modifier None Typical Low $40.74 Median $40.74 Typical High $41.69 | Professional | None | $40.74 | $40.74 | $41.69 |
4 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 $22.39 Median $22.39 Typical High $25.70 | Professional | 52 · Reduced service | $22.39 | $22.39 | $25.70 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $8.91 Median $8.91 Typical High $10.47 | Professional | 53 · Discontinued | $8.91 | $8.91 | $10.47 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $6.61 Median $6.76 Typical High $7.94 | Professional | 55 · Aftercare only | $6.61 | $6.76 | $7.94 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $4.47 Median $4.47 Typical High $5.37 | Professional | 56 · Pre-op care only | $4.47 | $4.47 | $5.37 |
Where Florida sits
The same service costs 4.7 times more in Wisconsin than in Kentucky. 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
$129
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.