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 $39.81 Median $3,311.31 Typical High $12,022.64 | Facility | None | $39.81 | $3,311.31 | $12,022.64 |
Aetna Setting Professional Modifier None Typical Low $26.30 Median $39.81 Typical High $57.54 | Professional | None | $26.30 | $39.81 | $57.54 |
Ambetter Setting Professional Modifier None Typical Low $42.66 Median $52.48 Typical High $60.26 | Professional | None | $42.66 | $52.48 | $60.26 |
AvMed Setting Facility Modifier None Typical Low $29.51 Median $42.66 Typical High $52.48 | Facility | None | $29.51 | $42.66 | $52.48 |
AvMed Setting Professional Modifier None Typical Low $29.51 Median $42.66 Typical High $56.23 | Professional | None | $29.51 | $42.66 | $56.23 |
Cigna Setting Facility Modifier None Typical Low $457.09 Median $2,290.87 Typical High $2,754.23 | Facility | None | $457.09 | $2,290.87 | $2,754.23 |
Cigna Setting Professional Modifier None Typical Low $46.77 Median $46.77 Typical High $46.77 | Professional | None | $46.77 | $46.77 | $46.77 |
Florida Blue Setting Facility Modifier None Typical Low $32.36 Median $53.70 Typical High $97.72 | Facility | None | $32.36 | $53.70 | $97.72 |
Florida Blue Setting Professional Modifier None Typical Low $34.67 Median $38.02 Typical High $47.86 | Professional | None | $34.67 | $38.02 | $47.86 |
Molina Setting Professional Modifier None Typical Low $52.48 Median $72.44 Typical High $141.25 | Professional | None | $52.48 | $72.44 | $141.25 |
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 $29.51 Median $47.86 Typical High $89.13 | Professional | None | $29.51 | $47.86 | $89.13 |
Wellpoint Setting Professional Modifier None Typical Low $27.54 Median $50.12 Typical High $50.12 | Professional | None | $27.54 | $50.12 | $50.12 |
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 $13.18 Median $17.78 Typical High $26.92 | Professional | 52 · Reduced service | $13.18 | $17.78 | $26.92 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $5.25 Median $7.08 Typical High $10.72 | Professional | 53 · Discontinued | $5.25 | $7.08 | $10.72 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $19.50 Median $26.30 Typical High $39.81 | Professional | 54 · Surgery only | $19.50 | $26.30 | $39.81 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $3.89 Median $5.25 Typical High $7.94 | Professional | 55 · Aftercare only | $3.89 | $5.25 | $7.94 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $2.63 Median $3.55 Typical High $5.37 | Professional | 56 · Pre-op care only | $2.63 | $3.55 | $5.37 |
Where Florida sits
The same service costs 2.8 times more in Alaska than in California. 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
$51.29
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.