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 $398.11 Median $3,019.95 Typical High $10,964.78 | Facility | None | $398.11 | $3,019.95 | $10,964.78 |
Aetna Setting Professional Modifier None Typical Low $154.88 Median $281.84 Typical High $446.68 | Professional | None | $154.88 | $281.84 | $446.68 |
AvMed Setting Facility Modifier None Typical Low $165.96 Median $263.03 Typical High $323.59 | Facility | None | $165.96 | $263.03 | $323.59 |
AvMed Setting Professional Modifier None Typical Low $165.96 Median $263.03 Typical High $398.11 | Professional | None | $165.96 | $263.03 | $398.11 |
Cigna Setting Facility Modifier None Typical Low $407.38 Median $812.83 Typical High $1,659.59 | Facility | None | $407.38 | $812.83 | $1,659.59 |
Cigna Setting Professional Modifier None Typical Low $288.40 Median $288.40 Typical High $288.40 | Professional | None | $288.40 | $288.40 | $288.40 |
Florida Blue Setting Professional Modifier None Typical Low $218.78 Median $234.42 Typical High $467.74 | Professional | None | $218.78 | $234.42 | $467.74 |
Molina Setting Professional Modifier None Typical Low $263.03 Median $346.74 Typical High $676.08 | Professional | None | $263.03 | $346.74 | $676.08 |
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 $181.97 Median $389.05 Typical High $812.83 | Professional | None | $181.97 | $389.05 | $812.83 |
Wellpoint Setting Professional Modifier None Typical Low $158.49 Median $316.23 Typical High $316.23 | Professional | None | $158.49 | $316.23 | $316.23 |
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 $77.62 Median $114.82 Typical High $223.87 | Professional | 52 · Reduced service | $77.62 | $114.82 | $223.87 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $30.90 Median $46.77 Typical High $89.13 | Professional | 53 · Discontinued | $30.90 | $46.77 | $89.13 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $117.49 Median $173.78 Typical High $331.13 | Professional | 54 · Surgery only | $117.49 | $173.78 | $331.13 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $23.44 Median $34.67 Typical High $66.07 | Professional | 55 · Aftercare only | $23.44 | $34.67 | $66.07 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $15.49 Median $22.91 Typical High $44.67 | Professional | 56 · Pre-op care only | $15.49 | $22.91 | $44.67 |
Where Florida sits
The same service costs 2.8 times more in Wisconsin than in Utah. 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· 42nd of 51
$316
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.