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 $56.23 Median $3,311.31 Typical High $12,022.64 | Facility | None | $56.23 | $3,311.31 | $12,022.64 |
Aetna Setting Professional Modifier None Typical Low $46.77 Median $56.23 Typical High $79.43 | Professional | None | $46.77 | $56.23 | $79.43 |
Ambetter Setting Professional Modifier None Typical Low $75.86 Median $75.86 Typical High $75.86 | Professional | None | $75.86 | $75.86 | $75.86 |
AvMed Setting Facility Modifier None Typical Low $60.26 Median $2,137.96 Typical High $11,748.98 | Facility | None | $60.26 | $2,137.96 | $11,748.98 |
AvMed Setting Professional Modifier None Typical Low $56.23 Median $64.57 Typical High $81.28 | Professional | None | $56.23 | $64.57 | $81.28 |
Cigna Setting Facility Modifier None Typical Low $37.15 Median $50.12 Typical High $83.18 | Facility | None | $37.15 | $50.12 | $83.18 |
Cigna Setting Professional Modifier None Typical Low $44.67 Median $56.23 Typical High $102.33 | Professional | None | $44.67 | $56.23 | $102.33 |
Florida Blue Setting Facility Modifier None Typical Low $60.26 Median $131.83 Typical High $3,019.95 | Facility | None | $60.26 | $131.83 | $3,019.95 |
Florida Blue Setting Professional Modifier None Typical Low $36.31 Median $58.88 Typical High $100.00 | Professional | None | $36.31 | $58.88 | $100.00 |
Molina Setting Professional Modifier None Typical Low $47.86 Median $66.07 Typical High $102.33 | Professional | None | $47.86 | $66.07 | $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 $45.71 Median $60.26 Typical High $109.65 | Professional | None | $45.71 | $60.26 | $109.65 |
Wellpoint Setting Professional Modifier None Typical Low $44.67 Median $72.44 Typical High $72.44 | Professional | None | $44.67 | $72.44 | $72.44 |
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 $23.44 Median $28.18 Typical High $38.90 | Professional | 52 · Reduced service | $23.44 | $28.18 | $38.90 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $9.33 Median $11.22 Typical High $15.49 | Professional | 53 · Discontinued | $9.33 | $11.22 | $15.49 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $35.48 Median $42.66 Typical High $57.54 | Professional | 54 · Surgery only | $35.48 | $42.66 | $57.54 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $7.08 Median $8.51 Typical High $11.48 | Professional | 55 · Aftercare only | $7.08 | $8.51 | $11.48 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $4.68 Median $5.62 Typical High $7.76 | Professional | 56 · Pre-op care only | $4.68 | $5.62 | $7.76 |
Where Florida sits
The same service costs 3.8 times more in Alaska than in Florida. 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· 51st of 51
$67.61
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.