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 $79.43 Median $2,630.27 Typical High $10,715.19 | Facility | None | $79.43 | $2,630.27 | $10,715.19 |
Aetna Setting Professional Modifier None Typical Low $46.77 Median $72.44 Typical High $104.71 | Professional | None | $46.77 | $72.44 | $104.71 |
Ambetter Setting Professional Modifier None Typical Low $77.62 Median $87.10 Typical High $107.15 | Professional | None | $77.62 | $87.10 | $107.15 |
AvMed Setting Facility Modifier None Typical Low $91.20 Median $4,897.79 Typical High $13,182.57 | Facility | None | $91.20 | $4,897.79 | $13,182.57 |
AvMed Setting Professional Modifier None Typical Low $39.81 Median $79.43 Typical High $109.65 | Professional | None | $39.81 | $79.43 | $109.65 |
Cigna Setting Facility Modifier None Typical Low $60.26 Median $61.66 Typical High $323.59 | Facility | None | $60.26 | $61.66 | $323.59 |
Cigna Setting Professional Modifier None Typical Low $31.62 Median $61.66 Typical High $112.20 | Professional | None | $31.62 | $61.66 | $112.20 |
Florida Blue Setting Facility Modifier None Typical Low $2,238.72 Median $3,311.31 Typical High $6,606.93 | Facility | None | $2,238.72 | $3,311.31 | $6,606.93 |
Florida Blue Setting Professional Modifier None Typical Low $54.95 Median $107.15 Typical High $199.53 | Professional | None | $54.95 | $107.15 | $199.53 |
Molina Setting Professional Modifier None Typical Low $36.31 Median $81.28 Typical High $199.53 | Professional | None | $36.31 | $81.28 | $199.53 |
United Setting Facility Modifier None Typical Low $169.82 Median $1,621.81 Typical High $5,248.07 | Facility | None | $169.82 | $1,621.81 | $5,248.07 |
United Setting Professional Modifier None Typical Low $35.48 Median $70.79 Typical High $125.89 | Professional | None | $35.48 | $70.79 | $125.89 |
Wellpoint Setting Professional Modifier None Typical Low $30.20 Median $70.79 Typical High $70.79 | Professional | None | $30.20 | $70.79 | $70.79 |
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 $23.44 Median $35.48 Typical High $47.86 | Professional | 52 · Reduced service | $23.44 | $35.48 | $47.86 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $9.33 Median $14.13 Typical High $19.05 | Professional | 53 · Discontinued | $9.33 | $14.13 | $19.05 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $34.67 Median $53.70 Typical High $72.44 | Professional | 54 · Surgery only | $34.67 | $53.70 | $72.44 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $6.92 Median $10.72 Typical High $14.45 | Professional | 55 · Aftercare only | $6.92 | $10.72 | $14.45 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $4.68 Median $7.08 Typical High $9.55 | Professional | 56 · Pre-op care only | $4.68 | $7.08 | $9.55 |
Where Florida sits
The same service costs 2.5 times more in North Carolina than in Florida. 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· 51st of 51
$70.79
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.