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 $131.83 Median $3,311.31 Typical High $12,022.64 | Facility | None | $131.83 | $3,311.31 | $12,022.64 |
Aetna Setting Professional Modifier None Typical Low $117.49 Median $131.83 Typical High $181.97 | Professional | None | $117.49 | $131.83 | $181.97 |
Ambetter Setting Professional Modifier None Typical Low $181.97 Median $181.97 Typical High $223.87 | Professional | None | $181.97 | $181.97 | $223.87 |
AvMed Setting Facility Modifier None Typical Low $134.90 Median $2,137.96 Typical High $11,748.98 | Facility | None | $134.90 | $2,137.96 | $11,748.98 |
AvMed Setting Professional Modifier None Typical Low $134.90 Median $162.18 Typical High $199.53 | Professional | None | $134.90 | $162.18 | $199.53 |
Cigna Setting Facility Modifier None Typical Low $52.48 Median $74.13 Typical High $144.54 | Facility | None | $52.48 | $74.13 | $144.54 |
Cigna Setting Professional Modifier None Typical Low $104.71 Median $151.36 Typical High $288.40 | Professional | None | $104.71 | $151.36 | $288.40 |
Florida Blue Setting Facility Modifier None Typical Low $60.26 Median $134.90 Typical High $4,466.84 | Facility | None | $60.26 | $134.90 | $4,466.84 |
Florida Blue Setting Professional Modifier None Typical Low $117.49 Median $125.89 Typical High $165.96 | Professional | None | $117.49 | $125.89 | $165.96 |
Molina Setting Professional Modifier None Typical Low $128.82 Median $194.98 Typical High $354.81 | Professional | None | $128.82 | $194.98 | $354.81 |
United Setting Facility Modifier None Typical Low $281.84 Median $660.69 Typical High $4,073.80 | Facility | None | $281.84 | $660.69 | $4,073.80 |
United Setting Professional Modifier None Typical Low $107.15 Median $169.82 Typical High $331.13 | Professional | None | $107.15 | $169.82 | $331.13 |
Wellpoint Setting Professional Modifier None Typical Low $91.20 Median $125.89 Typical High $125.89 | Professional | None | $91.20 | $125.89 | $125.89 |
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 $58.88 Median $66.07 Typical High $75.86 | Professional | 52 · Reduced service | $58.88 | $66.07 | $75.86 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $23.44 Median $26.92 Typical High $30.20 | Professional | 53 · Discontinued | $23.44 | $26.92 | $30.20 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $87.10 Median $100.00 Typical High $114.82 | Professional | 54 · Surgery only | $87.10 | $100.00 | $114.82 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $17.38 Median $19.95 Typical High $22.91 | Professional | 55 · Aftercare only | $17.38 | $19.95 | $22.91 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $11.75 Median $13.18 Typical High $15.14 | Professional | 56 · Pre-op care only | $11.75 | $13.18 | $15.14 |
Where Florida sits
The same service costs 2.9 times more in Alaska 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· 46th of 51
$158
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.