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 $407.38 Median $3,090.30 Typical High $11,481.54 | Facility | None | $407.38 | $3,090.30 | $11,481.54 |
Aetna Setting Professional Modifier None Typical Low $87.10 Median $109.65 Typical High $144.54 | Professional | None | $87.10 | $109.65 | $144.54 |
AvMed Setting Facility Modifier None Typical Low $120.23 Median $2,137.96 Typical High $11,748.98 | Facility | None | $120.23 | $2,137.96 | $11,748.98 |
AvMed Setting Professional Modifier None Typical Low $100.00 Median $117.49 Typical High $144.54 | Professional | None | $100.00 | $117.49 | $144.54 |
Cigna Setting Facility Modifier None Typical Low $323.59 Median $467.74 Typical High $1,659.59 | Facility | None | $323.59 | $467.74 | $1,659.59 |
Cigna Setting Professional Modifier None Typical Low $87.10 Median $117.49 Typical High $234.42 | Professional | None | $87.10 | $117.49 | $234.42 |
Florida Blue Setting Facility Modifier None Typical Low $363.08 Median $776.25 Typical High $4,466.84 | Facility | None | $363.08 | $776.25 | $4,466.84 |
Florida Blue Setting Professional Modifier None Typical Low $75.86 Median $91.20 Typical High $128.82 | Professional | None | $75.86 | $91.20 | $128.82 |
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 $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 $60.26 Median $125.89 Typical High $257.04 | Professional | None | $60.26 | $125.89 | $257.04 |
Wellpoint Setting Professional Modifier None Typical Low $87.10 Median $87.10 Typical High $120.23 | Professional | None | $87.10 | $87.10 | $120.23 |
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 $43.65 Median $53.70 Typical High $64.57 | Professional | 52 · Reduced service | $43.65 | $53.70 | $64.57 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $17.38 Median $21.38 Typical High $25.70 | Professional | 53 · Discontinued | $17.38 | $21.38 | $25.70 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $66.07 Median $81.28 Typical High $95.50 | Professional | 54 · Surgery only | $66.07 | $81.28 | $95.50 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $13.18 Median $16.22 Typical High $19.05 | Professional | 55 · Aftercare only | $13.18 | $16.22 | $19.05 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $8.71 Median $10.72 Typical High $12.88 | Professional | 56 · Pre-op care only | $8.71 | $10.72 | $12.88 |
Where Florida sits
The same service costs 4.4 times more in Alaska 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· 8th of 51
$302
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.