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 $64.57 Median $2,818.38 Typical High $10,964.78 | Facility | None | $64.57 | $2,818.38 | $10,964.78 |
Aetna Setting Professional Modifier None Typical Low $30.90 Median $63.10 Typical High $107.15 | Professional | None | $30.90 | $63.10 | $107.15 |
Ambetter Setting Professional Modifier None Typical Low $21.88 Median $61.66 Typical High $114.82 | Professional | None | $21.88 | $61.66 | $114.82 |
AvMed Setting Facility Modifier None Typical Low $54.95 Median $2,137.96 Typical High $11,748.98 | Facility | None | $54.95 | $2,137.96 | $11,748.98 |
AvMed Setting Professional Modifier None Typical Low $29.51 Median $64.57 Typical High $91.20 | Professional | None | $29.51 | $64.57 | $91.20 |
Cigna Setting Facility Modifier None Typical Low $50.12 Median $66.07 Typical High $123.03 | Facility | None | $50.12 | $66.07 | $123.03 |
Cigna Setting Professional Modifier None Typical Low $22.91 Median $54.95 Typical High $123.03 | Professional | None | $22.91 | $54.95 | $123.03 |
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 $53.70 Median $57.54 Typical High $141.25 | Professional | None | $53.70 | $57.54 | $141.25 |
Molina Setting Professional Modifier None Typical Low $70.79 Median $107.15 Typical High $208.93 | Professional | None | $70.79 | $107.15 | $208.93 |
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 $30.20 Median $63.10 Typical High $134.90 | Professional | None | $30.20 | $63.10 | $134.90 |
Wellpoint Setting Professional Modifier None Typical Low $20.42 Median $60.26 Typical High $60.26 | Professional | None | $20.42 | $60.26 | $60.26 |
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 $13.49 Median $29.51 Typical High $38.02 | Professional | 52 · Reduced service | $13.49 | $29.51 | $38.02 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $5.50 Median $11.75 Typical High $15.49 | Professional | 53 · Discontinued | $5.50 | $11.75 | $15.49 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $20.42 Median $44.67 Typical High $57.54 | Professional | 54 · Surgery only | $20.42 | $44.67 | $57.54 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $4.07 Median $8.91 Typical High $11.48 | Professional | 55 · Aftercare only | $4.07 | $8.91 | $11.48 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $2.75 Median $5.89 Typical High $7.59 | Professional | 56 · Pre-op care only | $2.75 | $5.89 | $7.59 |
Where Florida sits
The same service costs 3.1 times more in Wisconsin than in Nebraska. 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· 37th of 51
$79.43
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.