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 $104.71 Median $3,311.31 Typical High $12,022.64 | Facility | None | $104.71 | $3,311.31 | $12,022.64 |
Aetna Setting Professional Modifier None Typical Low $61.66 Median $100.00 Typical High $144.54 | Professional | None | $61.66 | $100.00 | $144.54 |
Ambetter Setting Professional Modifier None Typical Low $91.20 Median $95.50 Typical High $107.15 | Professional | None | $91.20 | $95.50 | $107.15 |
AvMed Setting Facility Modifier None Typical Low $75.86 Median $2,137.96 Typical High $11,748.98 | Facility | None | $75.86 | $2,137.96 | $11,748.98 |
AvMed Setting Professional Modifier None Typical Low $58.88 Median $100.00 Typical High $131.83 | Professional | None | $58.88 | $100.00 | $131.83 |
Cigna Setting Facility Modifier None Typical Low $52.48 Median $85.11 Typical High $165.96 | Facility | None | $52.48 | $85.11 | $165.96 |
Cigna Setting Professional Modifier None Typical Low $51.29 Median $85.11 Typical High $141.25 | Professional | None | $51.29 | $85.11 | $141.25 |
Florida Blue Setting Facility Modifier None Typical Low $60.26 Median $131.83 Typical High $3,019.95 | Facility | None | $60.26 | $131.83 | $3,019.95 |
Florida Blue Setting Professional Modifier None Typical Low $83.18 Median $93.33 Typical High $134.90 | Professional | None | $83.18 | $93.33 | $134.90 |
Molina Setting Professional Modifier None Typical Low $52.48 Median $93.33 Typical High $141.25 | Professional | None | $52.48 | $93.33 | $141.25 |
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 $50.12 Median $85.11 Typical High $154.88 | Professional | None | $50.12 | $85.11 | $154.88 |
Wellpoint Setting Professional Modifier None Typical Low $47.86 Median $93.33 Typical High $93.33 | Professional | None | $47.86 | $93.33 | $93.33 |
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 $30.90 Median $50.12 Typical High $58.88 | Professional | 52 · Reduced service | $30.90 | $50.12 | $58.88 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $12.30 Median $19.95 Typical High $23.44 | Professional | 53 · Discontinued | $12.30 | $19.95 | $23.44 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $46.77 Median $75.86 Typical High $89.13 | Professional | 54 · Surgery only | $46.77 | $75.86 | $89.13 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $9.33 Median $15.14 Typical High $17.78 | Professional | 55 · Aftercare only | $9.33 | $15.14 | $17.78 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $6.17 Median $10.00 Typical High $11.75 | Professional | 56 · Pre-op care only | $6.17 | $10.00 | $11.75 |
Where Florida sits
The same service costs 3.3 times more in Alaska than in Maryland. 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· 50th of 51
$97.72
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.