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 $33.88 Median $2,344.23 Typical High $12,022.64 | Facility | None | $33.88 | $2,344.23 | $12,022.64 |
Aetna Setting Professional Modifier None Typical Low $32.36 Median $45.71 Typical High $63.10 | Professional | None | $32.36 | $45.71 | $63.10 |
Ambetter Setting Professional Modifier None Typical Low $125.89 Median $125.89 Typical High $125.89 | Professional | None | $125.89 | $125.89 | $125.89 |
AvMed Setting Facility Modifier None Typical Low $53.70 Median $2,137.96 Typical High $11,748.98 | Facility | None | $53.70 | $2,137.96 | $11,748.98 |
AvMed Setting Professional Modifier None Typical Low $38.90 Median $51.29 Typical High $67.61 | Professional | None | $38.90 | $51.29 | $67.61 |
Cigna Setting Facility Modifier None Typical Low $50.12 Median $66.07 Typical High $724.44 | Facility | None | $50.12 | $66.07 | $724.44 |
Cigna Setting Professional Modifier None Typical Low $29.51 Median $42.66 Typical High $74.13 | Professional | None | $29.51 | $42.66 | $74.13 |
Florida Blue Setting Facility Modifier None Typical Low $34.67 Median $74.13 Typical High $3,981.07 | Facility | None | $34.67 | $74.13 | $3,981.07 |
Florida Blue Setting Professional Modifier None Typical Low $23.99 Median $46.77 Typical High $81.28 | Professional | None | $23.99 | $46.77 | $81.28 |
Molina Setting Professional Modifier None Typical Low $43.65 Median $60.26 Typical High $102.33 | Professional | None | $43.65 | $60.26 | $102.33 |
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 $32.36 Median $45.71 Typical High $79.43 | Professional | None | $32.36 | $45.71 | $79.43 |
Wellpoint Setting Professional Modifier None Typical Low $29.51 Median $57.54 Typical High $57.54 | Professional | None | $29.51 | $57.54 | $57.54 |
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 $15.85 Median $22.91 Typical High $26.92 | Professional | 52 · Reduced service | $15.85 | $22.91 | $26.92 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $6.46 Median $9.12 Typical High $10.96 | Professional | 53 · Discontinued | $6.46 | $9.12 | $10.96 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $23.99 Median $34.67 Typical High $40.74 | Professional | 54 · Surgery only | $23.99 | $34.67 | $40.74 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $4.79 Median $6.92 Typical High $8.13 | Professional | 55 · Aftercare only | $4.79 | $6.92 | $8.13 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $3.24 Median $4.57 Typical High $5.37 | Professional | 56 · Pre-op care only | $3.24 | $4.57 | $5.37 |
Where Florida sits
The same service costs 3.8 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
$50.12
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.