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 $27.54 Median $1,659.59 Typical High $10,471.29 | Facility | None | $27.54 | $1,659.59 | $10,471.29 |
Aetna Setting Professional Modifier None Typical Low $18.62 Median $51.29 Typical High $107.15 | Professional | None | $18.62 | $51.29 | $107.15 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $13.80 Median $33.11 Typical High $52.48 | Professional | 54 · Surgery only | $13.80 | $33.11 | $52.48 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $2.75 Median $6.61 Typical High $10.47 | Professional | 55 · Aftercare only | $2.75 | $6.61 | $10.47 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $1.86 Median $4.47 Typical High $7.08 | Professional | 56 · Pre-op care only | $1.86 | $4.47 | $7.08 |
Ambetter Setting Professional Modifier None Typical Low $23.99 Median $53.70 Typical High $83.18 | Professional | None | $23.99 | $53.70 | $83.18 |
AvMed Setting Facility Modifier None Typical Low $32.36 Median $83.18 Typical High $104.71 | Facility | None | $32.36 | $83.18 | $104.71 |
AvMed Setting Professional Modifier None Typical Low $31.62 Median $79.43 Typical High $107.15 | Professional | None | $31.62 | $79.43 | $107.15 |
Cigna Setting Facility Modifier None Typical Low $53.70 Median $53.70 Typical High $53.70 | Facility | None | $53.70 | $53.70 | $53.70 |
Cigna Setting Professional Modifier None Typical Low $25.12 Median $45.71 Typical High $72.44 | Professional | None | $25.12 | $45.71 | $72.44 |
Florida Blue Setting Facility Modifier None Typical Low $53.70 Median $194.98 Typical High $6,025.60 | Facility | None | $53.70 | $194.98 | $6,025.60 |
Florida Blue Setting Professional Modifier None Typical Low $47.86 Median $69.18 Typical High $109.65 | Professional | None | $47.86 | $69.18 | $109.65 |
Molina Setting Professional Modifier None Typical Low $26.30 Median $87.10 Typical High $134.90 | Professional | None | $26.30 | $87.10 | $134.90 |
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 $22.91 Median $46.77 Typical High $81.28 | Professional | None | $22.91 | $46.77 | $81.28 |
Wellpoint Setting Professional Modifier None Typical Low $23.99 Median $79.43 Typical High $79.43 | Professional | None | $23.99 | $79.43 | $79.43 |
2 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 |
|---|---|---|---|---|---|
Ambetter Setting Professional Modifier 58 · Staged procedure Typical Low $79.43 Median $79.43 Typical High $85.11 | Professional | 58 · Staged procedure | $79.43 | $79.43 | $85.11 |
Ambetter Setting Professional Modifier 59 · Distinct service Typical Low $28.18 Median $81.28 Typical High $87.10 | Professional | 59 · Distinct service | $28.18 | $81.28 | $87.10 |
Where Florida sits
The same service costs 2.8 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· 47th of 51
$60.26
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.