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 $588.84 Median $3,890.45 Typical High $12,022.64 | Facility | None | $588.84 | $3,890.45 | $12,022.64 |
Aetna Setting Professional Modifier None Typical Low $93.33 Median $107.15 Typical High $165.96 | Professional | None | $93.33 | $107.15 | $165.96 |
Ambetter Setting Professional Modifier None Typical Low $95.50 Median $102.33 Typical High $120.23 | Professional | None | $95.50 | $102.33 | $120.23 |
AvMed Setting Facility Modifier None Typical Low $100.00 Median $107.15 Typical High $134.90 | Facility | None | $100.00 | $107.15 | $134.90 |
AvMed Setting Professional Modifier None Typical Low $100.00 Median $123.03 Typical High $141.25 | Professional | None | $100.00 | $123.03 | $141.25 |
Cigna Setting Facility Modifier None Typical Low $199.53 Median $363.08 Typical High $426.58 | Facility | None | $199.53 | $363.08 | $426.58 |
Cigna Setting Professional Modifier None Typical Low $93.33 Median $107.15 Typical High $190.55 | Professional | None | $93.33 | $107.15 | $190.55 |
Florida Blue Setting Facility Modifier None Typical Low $213.80 Median $257.04 Typical High $257.04 | Facility | None | $213.80 | $257.04 | $257.04 |
Florida Blue Setting Professional Modifier None Typical Low $87.10 Median $95.50 Typical High $144.54 | Professional | None | $87.10 | $95.50 | $144.54 |
Molina Setting Professional Modifier None Typical Low $102.33 Median $138.04 Typical High $190.55 | Professional | None | $102.33 | $138.04 | $190.55 |
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 $60.26 Median $104.71 Typical High $190.55 | Professional | None | $60.26 | $104.71 | $190.55 |
Wellpoint Setting Professional Modifier None Typical Low $128.82 Median $128.82 Typical High $131.83 | Professional | None | $128.82 | $128.82 | $131.83 |
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 $42.66 Median $53.70 Typical High $63.10 | Professional | 52 · Reduced service | $42.66 | $53.70 | $63.10 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $16.98 Median $21.38 Typical High $25.12 | Professional | 53 · Discontinued | $16.98 | $21.38 | $25.12 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $64.57 Median $79.43 Typical High $93.33 | Professional | 54 · Surgery only | $64.57 | $79.43 | $93.33 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $12.88 Median $15.85 Typical High $19.05 | Professional | 55 · Aftercare only | $12.88 | $15.85 | $19.05 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $8.51 Median $10.72 Typical High $12.59 | Professional | 56 · Pre-op care only | $8.51 | $10.72 | $12.59 |
Where Florida sits
The same service costs 3.2 times more in Alaska 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· 50th of 51
$115
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.