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 $707.95 Median $6,025.60 Typical High $12,882.50 | Facility | None | $707.95 | $6,025.60 | $12,882.50 |
Aetna Setting Professional Modifier None Typical Low $114.82 Median $123.03 Typical High $177.83 | Professional | None | $114.82 | $123.03 | $177.83 |
Ambetter Setting Professional Modifier None Typical Low $144.54 Median $144.54 Typical High $169.82 | Professional | None | $144.54 | $144.54 | $169.82 |
AvMed Setting Facility Modifier None Typical Low $446.68 Median $2,137.96 Typical High $9,772.37 | Facility | None | $446.68 | $2,137.96 | $9,772.37 |
AvMed Setting Professional Modifier None Typical Low $112.20 Median $141.25 Typical High $173.78 | Professional | None | $112.20 | $141.25 | $173.78 |
Cigna Setting Facility Modifier None Typical Low $707.95 Median $2,041.74 Typical High $3,801.89 | Facility | None | $707.95 | $2,041.74 | $3,801.89 |
Cigna Setting Professional Modifier None Typical Low $100.00 Median $141.25 Typical High $263.03 | Professional | None | $100.00 | $141.25 | $263.03 |
Florida Blue Setting Facility Modifier None Typical Low $891.25 Median $1,905.46 Typical High $16,982.44 | Facility | None | $891.25 | $1,905.46 | $16,982.44 |
Florida Blue Setting Professional Modifier None Typical Low $91.20 Median $97.72 Typical High $177.83 | Professional | None | $91.20 | $97.72 | $177.83 |
Molina Setting Professional Modifier None Typical Low $112.20 Median $162.18 Typical High $288.40 | Professional | None | $112.20 | $162.18 | $288.40 |
United Setting Facility Modifier None Typical Low $954.99 Median $2,344.23 Typical High $10,000.00 | Facility | None | $954.99 | $2,344.23 | $10,000.00 |
United Setting Professional Modifier None Typical Low $60.26 Median $151.36 Typical High $288.40 | Professional | None | $60.26 | $151.36 | $288.40 |
Wellpoint Setting Professional Modifier None Typical Low $93.33 Median $93.33 Typical High $131.83 | Professional | None | $93.33 | $93.33 | $131.83 |
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 $57.54 Median $61.66 Typical High $72.44 | Professional | 52 · Reduced service | $57.54 | $61.66 | $72.44 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $22.91 Median $24.55 Typical High $28.84 | Professional | 53 · Discontinued | $22.91 | $24.55 | $28.84 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $87.10 Median $91.20 Typical High $109.65 | Professional | 54 · Surgery only | $87.10 | $91.20 | $109.65 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $17.38 Median $18.20 Typical High $21.88 | Professional | 55 · Aftercare only | $17.38 | $18.20 | $21.88 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $11.48 Median $12.30 Typical High $14.45 | Professional | 56 · Pre-op care only | $11.48 | $12.30 | $14.45 |
Where Florida sits
The same service costs 10.7 times more in Oklahoma than in New York. 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· 6th of 51
$617
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.