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 $2,951.21 Typical High $10,964.78 | Facility | None | $16.60 | $2,951.21 | $10,964.78 |
Aetna Setting Professional Modifier None Typical Low $10.72 Median $13.18 Typical High $26.30 | Professional | None | $10.72 | $13.18 | $26.30 |
Ambetter Setting Professional Modifier None Typical Low $8.13 Median $15.14 Typical High $18.20 | Professional | None | $8.13 | $15.14 | $18.20 |
AvMed Setting Facility Modifier None Typical Low $14.45 Median $2,137.96 Typical High $11,748.98 | Facility | None | $14.45 | $2,137.96 | $11,748.98 |
AvMed Setting Professional Modifier None Typical Low $13.18 Median $15.49 Typical High $18.20 | Professional | None | $13.18 | $15.49 | $18.20 |
Cigna Setting Facility Modifier None Typical Low $56.23 Median $346.74 Typical High $794.33 | Facility | None | $56.23 | $346.74 | $794.33 |
Cigna Setting Professional Modifier None Typical Low $10.47 Median $14.13 Typical High $25.12 | Professional | None | $10.47 | $14.13 | $25.12 |
Florida Blue Setting Facility Modifier None Typical Low $34.67 Median $70.79 Typical High $2,187.76 | Facility | None | $34.67 | $70.79 | $2,187.76 |
Florida Blue Setting Professional Modifier None Typical Low $9.12 Median $12.30 Typical High $15.49 | Professional | None | $9.12 | $12.30 | $15.49 |
Molina Setting Professional Modifier None Typical Low $25.70 Median $36.31 Typical High $72.44 | Professional | None | $25.70 | $36.31 | $72.44 |
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 $10.47 Median $16.60 Typical High $39.81 | Professional | None | $10.47 | $16.60 | $39.81 |
Wellpoint Setting Professional Modifier None Typical Low $13.18 Median $13.18 Typical High $16.60 | Professional | None | $13.18 | $13.18 | $16.60 |
6 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 $5.37 Median $5.50 Typical High $7.76 | Professional | 52 · Reduced service | $5.37 | $5.50 | $7.76 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $2.14 Median $2.19 Typical High $3.09 | Professional | 53 · Discontinued | $2.14 | $2.19 | $3.09 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $7.94 Median $8.32 Typical High $11.48 | Professional | 54 · Surgery only | $7.94 | $8.32 | $11.48 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $1.58 Median $1.66 Typical High $2.34 | Professional | 55 · Aftercare only | $1.58 | $1.66 | $2.34 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $1.07 Median $1.10 Typical High $1.55 | Professional | 56 · Pre-op care only | $1.07 | $1.10 | $1.55 |
Ambetter Setting Professional Modifier 50 · Both sides Typical Low $19.50 Median $22.91 Typical High $34.67 | Professional | 50 · Both sides | $19.50 | $22.91 | $34.67 |
Where Florida sits
The same service costs 7.4 times more in Kansas 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· 9th of 51
$35.48
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.