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 $354.81 Median $3,019.95 Typical High $10,964.78 | Facility | None | $354.81 | $3,019.95 | $10,964.78 |
Aetna Setting Professional Modifier None Typical Low $54.95 Median $89.13 Typical High $123.03 | Professional | None | $54.95 | $89.13 | $123.03 |
Ambetter Setting Professional Modifier None Typical Low $45.71 Median $83.18 Typical High $89.13 | Professional | None | $45.71 | $83.18 | $89.13 |
AvMed Setting Facility Modifier None Typical Low $74.13 Median $1,513.56 Typical High $9,772.37 | Facility | None | $74.13 | $1,513.56 | $9,772.37 |
AvMed Setting Professional Modifier None Typical Low $51.29 Median $77.62 Typical High $134.90 | Professional | None | $51.29 | $77.62 | $134.90 |
Cigna Setting Facility Modifier None Typical Low $50.12 Median $100.00 Typical High $1,659.59 | Facility | None | $50.12 | $100.00 | $1,659.59 |
Cigna Setting Professional Modifier None Typical Low $39.81 Median $61.66 Typical High $141.25 | Professional | None | $39.81 | $61.66 | $141.25 |
Florida Blue Setting Facility Modifier None Typical Low $60.26 Median $134.90 Typical High $4,466.84 | Facility | None | $60.26 | $134.90 | $4,466.84 |
Florida Blue Setting Professional Modifier None Typical Low $52.48 Median $89.13 Typical High $134.90 | Professional | None | $52.48 | $89.13 | $134.90 |
Molina Setting Professional Modifier None Typical Low $41.69 Median $83.18 Typical High $144.54 | Professional | None | $41.69 | $83.18 | $144.54 |
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 $41.69 Median $64.57 Typical High $151.36 | Professional | None | $41.69 | $64.57 | $151.36 |
Wellpoint Setting Professional Modifier None Typical Low $38.02 Median $69.18 Typical High $69.18 | Professional | None | $38.02 | $69.18 | $69.18 |
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 $27.54 Median $41.69 Typical High $61.66 | Professional | 52 · Reduced service | $27.54 | $41.69 | $61.66 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $10.96 Median $16.60 Typical High $24.55 | Professional | 53 · Discontinued | $10.96 | $16.60 | $24.55 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $41.69 Median $61.66 Typical High $91.20 | Professional | 54 · Surgery only | $41.69 | $61.66 | $91.20 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $8.32 Median $12.30 Typical High $18.62 | Professional | 55 · Aftercare only | $8.32 | $12.30 | $18.62 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $5.50 Median $8.32 Typical High $12.30 | Professional | 56 · Pre-op care only | $5.50 | $8.32 | $12.30 |
Where Florida sits
The same service costs 3.2 times more in Alaska than in Kentucky. 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· 49th of 51
$77.62
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.