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 $3,090.30 Typical High $10,964.78 | Facility | None | $602.56 | $3,090.30 | $10,964.78 |
Aetna Setting Professional Modifier None Typical Low $74.13 Median $630.96 Typical High $794.33 | Professional | None | $74.13 | $630.96 | $794.33 |
AvMed Setting Facility Modifier None Typical Low $588.84 Median $2,137.96 Typical High $11,748.98 | Facility | None | $588.84 | $2,137.96 | $11,748.98 |
AvMed Setting Professional Modifier None Typical Low $83.18 Median $794.33 Typical High $1,047.13 | Professional | None | $83.18 | $794.33 | $1,047.13 |
Cigna Setting Facility Modifier None Typical Low $331.13 Median $776.25 Typical High $1,659.59 | Facility | None | $331.13 | $776.25 | $1,659.59 |
Cigna Setting Professional Modifier None Typical Low $61.66 Median $645.65 Typical High $977.24 | Professional | None | $61.66 | $645.65 | $977.24 |
Florida Blue Setting Facility Modifier None Typical Low $489.78 Median $1,071.52 Typical High $5,370.32 | Facility | None | $489.78 | $1,071.52 | $5,370.32 |
Florida Blue Setting Professional Modifier None Typical Low $67.61 Median $562.34 Typical High $1,122.02 | Professional | None | $67.61 | $562.34 | $1,122.02 |
Molina Setting Professional Modifier None Typical Low $83.18 Median $831.76 Typical High $2,041.74 | Professional | None | $83.18 | $831.76 | $2,041.74 |
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 $61.66 Median $416.87 Typical High $1,000.00 | Professional | None | $61.66 | $416.87 | $1,000.00 |
Wellpoint Setting Professional Modifier None Typical Low $61.66 Median $112.20 Typical High $112.20 | Professional | None | $61.66 | $112.20 | $112.20 |
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 $36.31 Median $316.23 Typical High $398.11 | Professional | 52 · Reduced service | $36.31 | $316.23 | $398.11 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $14.79 Median $125.89 Typical High $162.18 | Professional | 53 · Discontinued | $14.79 | $125.89 | $162.18 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $54.95 Median $478.63 Typical High $602.56 | Professional | 54 · Surgery only | $54.95 | $478.63 | $602.56 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $10.96 Median $95.50 Typical High $120.23 | Professional | 55 · Aftercare only | $10.96 | $95.50 | $120.23 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $7.41 Median $63.10 Typical High $79.43 | Professional | 56 · Pre-op care only | $7.41 | $63.10 | $79.43 |
Where Florida sits
The same service costs 14.1 times more in Washington 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· 35th of 51
$646
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.