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 $5.75 Median $6.03 Typical High $32.36 | Facility | None | $5.75 | $6.03 | $32.36 |
Aetna Setting Professional Modifier None Typical Low $5.75 Median $10.00 Typical High $32.36 | Professional | None | $5.75 | $10.00 | $32.36 |
AvMed Setting Facility Modifier None Typical Low $28.84 Median $36.31 Typical High $37.15 | Facility | None | $28.84 | $36.31 | $37.15 |
AvMed Setting Professional Modifier None Typical Low $27.54 Median $30.20 Typical High $36.31 | Professional | None | $27.54 | $30.20 | $36.31 |
Cigna Setting Facility Modifier None Typical Low $46.77 Median $46.77 Typical High $46.77 | Facility | None | $46.77 | $46.77 | $46.77 |
Cigna Setting Professional Modifier None Typical Low $29.51 Median $29.51 Typical High $29.51 | Professional | None | $29.51 | $29.51 | $29.51 |
Florida Blue Setting Facility Modifier None Typical Low $89.13 Median $89.13 Typical High $91.20 | Facility | None | $89.13 | $89.13 | $91.20 |
Florida Blue Setting Professional Modifier None Typical Low $23.99 Median $36.31 Typical High $36.31 | Professional | None | $23.99 | $36.31 | $36.31 |
United Setting Facility Modifier None Typical Low $54.95 Median $58.88 Typical High $58.88 | Facility | None | $54.95 | $58.88 | $58.88 |
United Setting Professional Modifier None Typical Low $16.60 Median $34.67 Typical High $60.26 | Professional | None | $16.60 | $34.67 | $60.26 |
Wellpoint Setting Professional Modifier None Typical Low $23.99 Median $23.99 Typical High $34.67 | Professional | None | $23.99 | $23.99 | $34.67 |
4 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 $2.82 Median $3.63 Typical High $11.75 | Professional | 52 · Reduced service | $2.82 | $3.63 | $11.75 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $1.12 Median $1.45 Typical High $4.68 | Professional | 53 · Discontinued | $1.12 | $1.45 | $4.68 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $0.85 Median $1.10 Typical High $3.47 | Professional | 55 · Aftercare only | $0.85 | $1.10 | $3.47 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $0.56 Median $0.72 Typical High $2.34 | Professional | 56 · Pre-op care only | $0.56 | $0.72 | $2.34 |
Where Florida sits
The same service costs 4.6 times more in Alabama than in Missouri. 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· 13th of 51
$34.67
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.