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 $501.19 Median $3,311.31 Typical High $11,481.54 | Facility | None | $501.19 | $3,311.31 | $11,481.54 |
Aetna Setting Professional Modifier None Typical Low $457.09 Median $501.19 Typical High $676.08 | Professional | None | $457.09 | $501.19 | $676.08 |
AvMed Setting Facility Modifier None Typical Low $363.08 Median $2,691.53 Typical High $12,882.50 | Facility | None | $363.08 | $2,691.53 | $12,882.50 |
AvMed Setting Professional Modifier None Typical Low $302.00 Median $380.19 Typical High $457.09 | Professional | None | $302.00 | $380.19 | $457.09 |
Cigna Setting Facility Modifier None Typical Low $812.83 Median $2,754.23 Typical High $6,760.83 | Facility | None | $812.83 | $2,754.23 | $6,760.83 |
Cigna Setting Professional Modifier None Typical Low $416.87 Median $436.52 Typical High $891.25 | Professional | None | $416.87 | $436.52 | $891.25 |
Florida Blue Setting Facility Modifier None Typical Low $1,659.59 Median $2,754.23 Typical High $5,011.87 | Facility | None | $1,659.59 | $2,754.23 | $5,011.87 |
Florida Blue Setting Professional Modifier None Typical Low $128.82 Median $380.19 Typical High $436.52 | Professional | None | $128.82 | $380.19 | $436.52 |
Molina Setting Professional Modifier None Typical Low $134.90 Median $162.18 Typical High $223.87 | Professional | None | $134.90 | $162.18 | $223.87 |
United Setting Facility Modifier None Typical Low $1,000.00 Median $2,884.03 Typical High $10,715.19 | Facility | None | $1,000.00 | $2,884.03 | $10,715.19 |
United Setting Professional Modifier None Typical Low $218.78 Median $295.12 Typical High $575.44 | Professional | None | $218.78 | $295.12 | $575.44 |
Wellpoint Setting Professional Modifier None Typical Low $134.90 Median $134.90 Typical High $380.19 | Professional | None | $134.90 | $134.90 | $380.19 |
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 $229.09 Median $251.19 Typical High $323.59 | Professional | 52 · Reduced service | $229.09 | $251.19 | $323.59 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $91.20 Median $102.33 Typical High $128.82 | Professional | 53 · Discontinued | $91.20 | $102.33 | $128.82 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $346.74 Median $380.19 Typical High $489.78 | Professional | 54 · Surgery only | $346.74 | $380.19 | $489.78 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $69.18 Median $75.86 Typical High $97.72 | Professional | 55 · Aftercare only | $69.18 | $75.86 | $97.72 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $45.71 Median $50.12 Typical High $64.57 | Professional | 56 · Pre-op care only | $45.71 | $50.12 | $64.57 |
Where Florida sits
The same service costs 10.5 times more in Alaska than in Hawaii. 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· 42nd of 51
$501
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.