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 $524.81 Median $3,162.28 Typical High $10,964.78 | Facility | None | $524.81 | $3,162.28 | $10,964.78 |
Aetna Setting Professional Modifier None Typical Low $213.80 Median $588.84 Typical High $3,235.94 | Professional | None | $213.80 | $588.84 | $3,235.94 |
Ambetter Setting Professional Modifier None Typical Low $100.00 Median $100.00 Typical High $165.96 | Professional | None | $100.00 | $100.00 | $165.96 |
AvMed Setting Facility Modifier None Typical Low $630.96 Median $2,818.38 Typical High $11,748.98 | Facility | None | $630.96 | $2,818.38 | $11,748.98 |
AvMed Setting Professional Modifier None Typical Low $223.87 Median $2,187.76 Typical High $2,818.38 | Professional | None | $223.87 | $2,187.76 | $2,818.38 |
Cigna Setting Facility Modifier None Typical Low $478.63 Median $4,897.79 Typical High $7,762.47 | Facility | None | $478.63 | $4,897.79 | $7,762.47 |
Cigna Setting Professional Modifier None Typical Low $181.97 Median $1,949.84 Typical High $4,570.88 | Professional | None | $181.97 | $1,949.84 | $4,570.88 |
Florida Blue Setting Facility Modifier None Typical Low $1,778.28 Median $3,548.13 Typical High $16,982.44 | Facility | None | $1,778.28 | $3,548.13 | $16,982.44 |
Florida Blue Setting Professional Modifier None Typical Low $1,778.28 Median $1,905.46 Typical High $3,162.28 | Professional | None | $1,778.28 | $1,905.46 | $3,162.28 |
Molina Setting Professional Modifier None Typical Low $2,398.83 Median $3,388.44 Typical High $6,165.95 | Professional | None | $2,398.83 | $3,388.44 | $6,165.95 |
United Setting Facility Modifier None Typical Low $1,230.27 Median $3,630.78 Typical High $12,589.25 | Facility | None | $1,230.27 | $3,630.78 | $12,589.25 |
United Setting Professional Modifier None Typical Low $223.87 Median $2,041.74 Typical High $5,495.41 | Professional | None | $223.87 | $2,041.74 | $5,495.41 |
Wellpoint Setting Professional Modifier None Typical Low $204.17 Median $2,630.27 Typical High $2,630.27 | Professional | None | $204.17 | $2,630.27 | $2,630.27 |
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 $107.15 Median $245.47 Typical High $1,479.11 | Professional | 52 · Reduced service | $107.15 | $245.47 | $1,479.11 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $42.66 Median $100.00 Typical High $588.84 | Professional | 53 · Discontinued | $42.66 | $100.00 | $588.84 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $158.49 Median $371.54 Typical High $2,187.76 | Professional | 54 · Surgery only | $158.49 | $371.54 | $2,187.76 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $31.62 Median $74.13 Typical High $436.52 | Professional | 55 · Aftercare only | $31.62 | $74.13 | $436.52 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $21.38 Median $50.12 Typical High $295.12 | Professional | 56 · Pre-op care only | $21.38 | $50.12 | $295.12 |
Where Florida sits
The same service costs 11.2 times more in Alaska than in Nebraska. 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· 29th of 51
$2,630
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.