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 $602.56 Median $3,235.94 Typical High $10,964.78 | Facility | None | $602.56 | $3,235.94 | $10,964.78 |
Aetna Setting Professional Modifier None Typical Low $208.93 Median $218.78 Typical High $269.15 | Professional | None | $208.93 | $218.78 | $269.15 |
AvMed Setting Facility Modifier None Typical Low $208.93 Median $2,137.96 Typical High $11,748.98 | Facility | None | $208.93 | $2,137.96 | $11,748.98 |
AvMed Setting Professional Modifier None Typical Low $158.49 Median $181.97 Typical High $239.88 | Professional | None | $158.49 | $181.97 | $239.88 |
Cigna Setting Facility Modifier None Typical Low $489.78 Median $776.25 Typical High $3,311.31 | Facility | None | $489.78 | $776.25 | $3,311.31 |
Cigna Setting Professional Modifier None Typical Low $162.18 Median $169.82 Typical High $309.03 | Professional | None | $162.18 | $169.82 | $309.03 |
Florida Blue Setting Facility Modifier None Typical Low $380.19 Median $776.25 Typical High $5,370.32 | Facility | None | $380.19 | $776.25 | $5,370.32 |
Florida Blue Setting Professional Modifier None Typical Low $169.82 Median $354.81 Typical High $478.63 | Professional | None | $169.82 | $354.81 | $478.63 |
Molina Setting Professional Modifier None Typical Low $154.88 Median $173.78 Typical High $426.58 | Professional | None | $154.88 | $173.78 | $426.58 |
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 $165.96 Median $213.80 Typical High $354.81 | Professional | None | $165.96 | $213.80 | $354.81 |
Wellpoint Setting Professional Modifier None Typical Low $158.49 Median $158.49 Typical High $158.49 | Professional | None | $158.49 | $158.49 | $158.49 |
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 $104.71 Median $109.65 Typical High $134.90 | Professional | 52 · Reduced service | $104.71 | $109.65 | $134.90 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $41.69 Median $43.65 Typical High $53.70 | Professional | 53 · Discontinued | $41.69 | $43.65 | $53.70 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $158.49 Median $165.96 Typical High $199.53 | Professional | 54 · Surgery only | $158.49 | $165.96 | $199.53 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $31.62 Median $33.11 Typical High $40.74 | Professional | 55 · Aftercare only | $31.62 | $33.11 | $40.74 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $20.89 Median $21.88 Typical High $26.92 | Professional | 56 · Pre-op care only | $20.89 | $21.88 | $26.92 |
Where Florida sits
The same service costs 4.7 times more in Wyoming than in Utah. 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· 49th of 51
$214
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.