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 $457.09 Median $3,090.30 Typical High $10,964.78 | Facility | None | $457.09 | $3,090.30 | $10,964.78 |
Aetna Setting Professional Modifier None Typical Low $20.42 Median $30.90 Typical High $36.31 | Professional | None | $20.42 | $30.90 | $36.31 |
Ambetter Setting Professional Modifier None Typical Low $31.62 Median $31.62 Typical High $32.36 | Professional | None | $31.62 | $31.62 | $32.36 |
AvMed Setting Facility Modifier None Typical Low $23.99 Median $2,137.96 Typical High $11,748.98 | Facility | None | $23.99 | $2,137.96 | $11,748.98 |
AvMed Setting Professional Modifier None Typical Low $22.39 Median $28.18 Typical High $38.90 | Professional | None | $22.39 | $28.18 | $38.90 |
Cigna Setting Facility Modifier None Typical Low $15.85 Median $33.88 Typical High $2,187.76 | Facility | None | $15.85 | $33.88 | $2,187.76 |
Cigna Setting Professional Modifier None Typical Low $17.78 Median $23.44 Typical High $48.98 | Professional | None | $17.78 | $23.44 | $48.98 |
Florida Blue Setting Facility Modifier None Typical Low $31.62 Median $70.79 Typical High $3,019.95 | Facility | None | $31.62 | $70.79 | $3,019.95 |
Florida Blue Setting Professional Modifier None Typical Low $15.85 Median $32.36 Typical High $102.33 | Professional | None | $15.85 | $32.36 | $102.33 |
Molina Setting Professional Modifier None Typical Low $38.02 Median $45.71 Typical High $186.21 | Professional | None | $38.02 | $45.71 | $186.21 |
United Setting Facility Modifier None Typical Low $81.28 Median $302.00 Typical High $2,818.38 | Facility | None | $81.28 | $302.00 | $2,818.38 |
United Setting Professional Modifier None Typical Low $18.20 Median $25.70 Typical High $53.70 | Professional | None | $18.20 | $25.70 | $53.70 |
Wellpoint Setting Professional Modifier None Typical Low $21.38 Median $33.11 Typical High $33.11 | Professional | None | $21.38 | $33.11 | $33.11 |
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 $10.23 Median $15.14 Typical High $18.20 | Professional | 52 · Reduced service | $10.23 | $15.14 | $18.20 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $4.07 Median $6.03 Typical High $7.24 | Professional | 53 · Discontinued | $4.07 | $6.03 | $7.24 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $15.49 Median $22.91 Typical High $27.54 | Professional | 54 · Surgery only | $15.49 | $22.91 | $27.54 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $3.09 Median $4.57 Typical High $5.50 | Professional | 55 · Aftercare only | $3.09 | $4.57 | $5.50 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $2.04 Median $3.02 Typical High $3.63 | Professional | 56 · Pre-op care only | $2.04 | $3.02 | $3.63 |
Where Florida sits
The same service costs 3.5 times more in Alaska than in Maryland. 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· 48th of 51
$30.20
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.