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 $407.38 Median $3,235.94 Typical High $11,481.54 | Facility | None | $407.38 | $3,235.94 | $11,481.54 |
Aetna Setting Professional Modifier None Typical Low $1.82 Median $2.09 Typical High $407.38 | Professional | None | $1.82 | $2.09 | $407.38 |
Ambetter Setting Professional Modifier None Typical Low $4.68 Median $4.68 Typical High $4.68 | Professional | None | $4.68 | $4.68 | $4.68 |
AvMed Setting Facility Modifier None Typical Low $9.33 Median $9.33 Typical High $9.33 | Facility | None | $9.33 | $9.33 | $9.33 |
AvMed Setting Professional Modifier None Typical Low $3.02 Median $8.91 Typical High $9.33 | Professional | None | $3.02 | $8.91 | $9.33 |
Cigna Setting Facility Modifier None Typical Low $1.74 Median $2.63 Typical High $37.15 | Facility | None | $1.74 | $2.63 | $37.15 |
Cigna Setting Professional Modifier None Typical Low $1.26 Median $1.26 Typical High $9.33 | Professional | None | $1.26 | $1.26 | $9.33 |
Florida Blue Setting Facility Modifier None Typical Low $2.24 Median $17.38 Typical High $17.38 | Facility | None | $2.24 | $17.38 | $17.38 |
Florida Blue Setting Professional Modifier None Typical Low $2.24 Median $5.62 Typical High $8.32 | Professional | None | $2.24 | $5.62 | $8.32 |
Molina Setting Professional Modifier None Typical Low $6.03 Median $6.03 Typical High $6.17 | Professional | None | $6.03 | $6.03 | $6.17 |
United Setting Facility Modifier None Typical Low $9.33 Median $9.33 Typical High $9.33 | Facility | None | $9.33 | $9.33 | $9.33 |
United Setting Professional Modifier None Typical Low $1.05 Median $3.02 Typical High $54.95 | Professional | None | $1.05 | $3.02 | $54.95 |
Wellpoint Setting Professional Modifier None Typical Low $1.20 Median $1.20 Typical High $9.33 | Professional | None | $1.20 | $1.20 | $9.33 |
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 $0.89 Median $0.98 Typical High $1.38 | Professional | 52 · Reduced service | $0.89 | $0.98 | $1.38 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $0.36 Median $0.39 Typical High $0.55 | Professional | 53 · Discontinued | $0.36 | $0.39 | $0.55 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $1.35 Median $1.45 Typical High $2.04 | Professional | 54 · Surgery only | $1.35 | $1.45 | $2.04 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $0.27 Median $0.28 Typical High $0.41 | Professional | 55 · Aftercare only | $0.27 | $0.28 | $0.41 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $0.18 Median $0.20 Typical High $0.28 | Professional | 56 · Pre-op care only | $0.18 | $0.20 | $0.28 |
Where Florida sits
The same service costs 25.7 times more in Kansas than in Delaware. 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· 39th of 51
$4.17
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.