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 $380.19 Median $3,090.30 Typical High $10,964.78 | Facility | None | $380.19 | $3,090.30 | $10,964.78 |
Aetna Setting Professional Modifier None Typical Low $70.79 Median $131.83 Typical High $165.96 | Professional | None | $70.79 | $131.83 | $165.96 |
AvMed Setting Facility Modifier None Typical Low $251.19 Median $1,348.96 Typical High $9,549.93 | Facility | None | $251.19 | $1,348.96 | $9,549.93 |
AvMed Setting Professional Modifier None Typical Low $87.10 Median $181.97 Typical High $239.88 | Professional | None | $87.10 | $181.97 | $239.88 |
Cigna Setting Facility Modifier None Typical Low $323.59 Median $1,584.89 Typical High $2,691.53 | Facility | None | $323.59 | $1,584.89 | $2,691.53 |
Cigna Setting Professional Modifier None Typical Low $61.66 Median $144.54 Typical High $218.78 | Professional | None | $61.66 | $144.54 | $218.78 |
Florida Blue Setting Facility Modifier None Typical Low $524.81 Median $1,071.52 Typical High $11,748.98 | Facility | None | $524.81 | $1,071.52 | $11,748.98 |
Florida Blue Setting Professional Modifier None Typical Low $81.28 Median $128.82 Typical High $257.04 | Professional | None | $81.28 | $128.82 | $257.04 |
Molina Setting Professional Modifier None Typical Low $85.11 Median $165.96 Typical High $407.38 | Professional | None | $85.11 | $165.96 | $407.38 |
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 $63.10 Median $120.23 Typical High $208.93 | Professional | None | $63.10 | $120.23 | $208.93 |
Wellpoint Setting Professional Modifier None Typical Low $63.10 Median $81.28 Typical High $81.28 | Professional | None | $63.10 | $81.28 | $81.28 |
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 $35.48 Median $66.07 Typical High $83.18 | Professional | 52 · Reduced service | $35.48 | $66.07 | $83.18 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $14.13 Median $26.30 Typical High $33.11 | Professional | 53 · Discontinued | $14.13 | $26.30 | $33.11 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $52.48 Median $100.00 Typical High $123.03 | Professional | 54 · Surgery only | $52.48 | $100.00 | $123.03 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $10.47 Median $19.95 Typical High $25.12 | Professional | 55 · Aftercare only | $10.47 | $19.95 | $25.12 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $7.08 Median $13.18 Typical High $16.60 | Professional | 56 · Pre-op care only | $7.08 | $13.18 | $16.60 |
Ambetter Setting Professional Modifier 33 · Preventive service Typical Low $83.18 Median $83.18 Typical High $83.18 | Professional | 33 · Preventive service | $83.18 | $83.18 | $83.18 |
Where Florida sits
The same service costs 4.5 times more in Alaska than in Washington, DC. 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· 44th of 51
$145
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.