How much rates vary
Distribution of negotiated rates across all payers (price axis is log-scale). Small sample; interpret with caution. 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 $12.02 Median $12.02 Typical High $12.02 | Facility | None | $12.02 | $12.02 | $12.02 |
Aetna Setting Professional Modifier None Typical Low $12.02 Median $12.02 Typical High $12.02 | Professional | None | $12.02 | $12.02 | $12.02 |
Cigna Setting Facility Modifier None Typical Low $64.57 Median $64.57 Typical High $64.57 | Facility | None | $64.57 | $64.57 | $64.57 |
Cigna Setting Professional Modifier None Typical Low $11.75 Median $11.75 Typical High $11.75 | Professional | None | $11.75 | $11.75 | $11.75 |
Florida Blue Setting Professional Modifier None Typical Low $134.90 Median $162.18 Typical High $218.78 | Professional | None | $134.90 | $162.18 | $218.78 |
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 Professional Modifier None Typical Low $34.67 Median $39.81 Typical High $60.26 | Professional | None | $34.67 | $39.81 | $60.26 |
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 $6.03 Median $6.03 Typical High $6.03 | Professional | 52 · Reduced service | $6.03 | $6.03 | $6.03 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $2.40 Median $2.40 Typical High $2.40 | Professional | 53 · Discontinued | $2.40 | $2.40 | $2.40 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $8.91 Median $8.91 Typical High $8.91 | Professional | 54 · Surgery only | $8.91 | $8.91 | $8.91 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $1.82 Median $1.82 Typical High $1.82 | Professional | 55 · Aftercare only | $1.82 | $1.82 | $1.82 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $1.20 Median $1.20 Typical High $1.20 | Professional | 56 · Pre-op care only | $1.20 | $1.20 | $1.20 |
Where Florida sits
The same service costs 20.9 times more in Illinois than in Nevada. 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· 15th of 51
$12.02
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.