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 $16.60 Median $3,311.31 Typical High $12,022.64 | Facility | None | $16.60 | $3,311.31 | $12,022.64 |
Aetna Setting Professional Modifier None Typical Low $15.85 Median $16.60 Typical High $48.98 | Professional | None | $15.85 | $16.60 | $48.98 |
Ambetter Setting Professional Modifier None Typical Low $18.20 Median $34.67 Typical High $36.31 | Professional | None | $18.20 | $34.67 | $36.31 |
AvMed Setting Facility Modifier None Typical Low $18.62 Median $2,137.96 Typical High $11,748.98 | Facility | None | $18.62 | $2,137.96 | $11,748.98 |
AvMed Setting Professional Modifier None Typical Low $14.13 Median $19.05 Typical High $46.77 | Professional | None | $14.13 | $19.05 | $46.77 |
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 $13.49 Median $15.85 Typical High $53.70 | Professional | None | $13.49 | $15.85 | $53.70 |
Florida Blue Setting Facility Modifier None Typical Low $34.67 Median $70.79 Typical High $2,137.96 | Facility | None | $34.67 | $70.79 | $2,137.96 |
Florida Blue Setting Professional Modifier None Typical Low $13.18 Median $22.39 Typical High $60.26 | Professional | None | $13.18 | $22.39 | $60.26 |
Molina Setting Professional Modifier None Typical Low $15.14 Median $16.60 Typical High $25.12 | Professional | None | $15.14 | $16.60 | $25.12 |
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 $19.05 Median $28.84 Typical High $58.88 | Professional | None | $19.05 | $28.84 | $58.88 |
Wellpoint Setting Professional Modifier None Typical Low $14.45 Median $17.38 Typical High $17.38 | Professional | None | $14.45 | $17.38 | $17.38 |
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 $7.94 Median $8.32 Typical High $12.30 | Professional | 52 · Reduced service | $7.94 | $8.32 | $12.30 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $3.16 Median $3.39 Typical High $4.90 | Professional | 53 · Discontinued | $3.16 | $3.39 | $4.90 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $11.75 Median $12.59 Typical High $18.20 | Professional | 54 · Surgery only | $11.75 | $12.59 | $18.20 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $2.34 Median $2.51 Typical High $3.63 | Professional | 55 · Aftercare only | $2.34 | $2.51 | $3.63 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $1.58 Median $1.66 Typical High $2.45 | Professional | 56 · Pre-op care only | $1.58 | $1.66 | $2.45 |
Where Florida sits
The same service costs 4.3 times more in Wyoming than in New York. 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
$25.70
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.