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 $1,148.15 Median $8,912.51 Typical High $19,952.62 | Facility | None | $1,148.15 | $8,912.51 | $19,952.62 |
Aetna Setting Professional Modifier None Typical Low $912.01 Median $1,148.15 Typical High $11,481.54 | Professional | None | $912.01 | $1,148.15 | $11,481.54 |
AvMed Setting Facility Modifier None Typical Low $12,022.64 Median $12,589.25 Typical High $19,054.61 | Facility | None | $12,022.64 | $12,589.25 | $19,054.61 |
Cigna Setting Facility Modifier None Typical Low $11,748.98 Median $15,488.17 Typical High $26,915.35 | Facility | None | $11,748.98 | $15,488.17 | $26,915.35 |
Florida Blue Setting Facility Modifier None Typical Low $2,951.21 Median $7,244.36 Typical High $35,481.34 | Facility | None | $2,951.21 | $7,244.36 | $35,481.34 |
Molina Setting Professional Modifier None Typical Low $39.81 Median $39.81 Typical High $39.81 | Professional | None | $39.81 | $39.81 | $39.81 |
United Setting Facility Modifier None Typical Low $2,511.89 Median $10,232.93 Typical High $34,673.69 | Facility | None | $2,511.89 | $10,232.93 | $34,673.69 |
Wellpoint Setting Professional Modifier None Typical Low $3.98 Median $3.98 Typical High $3.98 | Professional | None | $3.98 | $3.98 | $3.98 |
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 $457.09 Median $575.44 Typical High $575.44 | Professional | 52 · Reduced service | $457.09 | $575.44 | $575.44 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $181.97 Median $229.09 Typical High $229.09 | Professional | 53 · Discontinued | $181.97 | $229.09 | $229.09 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $691.83 Median $851.14 Typical High $851.14 | Professional | 54 · Surgery only | $691.83 | $851.14 | $851.14 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $138.04 Median $173.78 Typical High $173.78 | Professional | 55 · Aftercare only | $138.04 | $173.78 | $173.78 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $91.20 Median $114.82 Typical High $114.82 | Professional | 56 · Pre-op care only | $91.20 | $114.82 | $114.82 |
Where Florida sits
The same service costs 5754.4 times more in Oklahoma than in Maine. 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· 35th of 51
$8,128
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.