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 $74.13 Median $102.33 Typical High $123.03 | Professional | None | $74.13 | $102.33 | $123.03 |
AvMed Setting Facility Modifier None Typical Low $114.82 Median $2,137.96 Typical High $11,748.98 | Facility | None | $114.82 | $2,137.96 | $11,748.98 |
AvMed Setting Professional Modifier None Typical Low $97.72 Median $114.82 Typical High $141.25 | Professional | None | $97.72 | $114.82 | $141.25 |
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 $81.28 Median $112.20 Typical High $239.88 | Professional | None | $81.28 | $112.20 | $239.88 |
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 $79.43 Median $85.11 Typical High $131.83 | Professional | None | $79.43 | $85.11 | $131.83 |
Molina Setting Professional Modifier None Typical Low $83.18 Median $123.03 Typical High $223.87 | Professional | None | $83.18 | $123.03 | $223.87 |
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 $123.03 Typical High $229.09 | Professional | None | $60.26 | $123.03 | $229.09 |
Wellpoint Setting Professional Modifier None Typical Low $83.18 Median $83.18 Typical High $114.82 | Professional | None | $83.18 | $83.18 | $114.82 |
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 $37.15 Median $51.29 Typical High $60.26 | Professional | 52 · Reduced service | $37.15 | $51.29 | $60.26 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $14.79 Median $20.42 Typical High $24.55 | Professional | 53 · Discontinued | $14.79 | $20.42 | $24.55 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $54.95 Median $75.86 Typical High $91.20 | Professional | 54 · Surgery only | $54.95 | $75.86 | $91.20 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $10.96 Median $15.49 Typical High $18.20 | Professional | 55 · Aftercare only | $10.96 | $15.49 | $18.20 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $7.41 Median $10.23 Typical High $12.02 | Professional | 56 · Pre-op care only | $7.41 | $10.23 | $12.02 |
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
$275
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.