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 $33.88 Median $51.29 Typical High $117.49 | Facility | None | $33.88 | $51.29 | $117.49 |
Aetna Setting Professional Modifier None Typical Low $33.88 Median $51.29 Typical High $83.18 | Professional | None | $33.88 | $51.29 | $83.18 |
Ambetter Setting Professional Modifier None Typical Low $39.81 Median $74.13 Typical High $93.33 | Professional | None | $39.81 | $74.13 | $93.33 |
AvMed Setting Facility Modifier None Typical Low $66.07 Median $2,137.96 Typical High $11,748.98 | Facility | None | $66.07 | $2,137.96 | $11,748.98 |
AvMed Setting Professional Modifier None Typical Low $40.74 Median $63.10 Typical High $83.18 | Professional | None | $40.74 | $63.10 | $83.18 |
Cigna Setting Facility Modifier None Typical Low $50.12 Median $66.07 Typical High $724.44 | Facility | None | $50.12 | $66.07 | $724.44 |
Cigna Setting Professional Modifier None Typical Low $28.84 Median $46.77 Typical High $79.43 | Professional | None | $28.84 | $46.77 | $79.43 |
Florida Blue Setting Facility Modifier None Typical Low $34.67 Median $70.79 Typical High $2,137.96 | Facility | None | $34.67 | $70.79 | $2,137.96 |
Florida Blue Setting Professional Modifier None Typical Low $25.70 Median $60.26 Typical High $85.11 | Professional | None | $25.70 | $60.26 | $85.11 |
Molina Setting Professional Modifier None Typical Low $35.48 Median $56.23 Typical High $97.72 | Professional | None | $35.48 | $56.23 | $97.72 |
United Setting Facility Modifier None Typical Low $81.28 Median $302.00 Typical High $2,754.23 | Facility | None | $81.28 | $302.00 | $2,754.23 |
United Setting Professional Modifier None Typical Low $28.84 Median $45.71 Typical High $89.13 | Professional | None | $28.84 | $45.71 | $89.13 |
Wellpoint Setting Professional Modifier None Typical Low $31.62 Median $58.88 Typical High $58.88 | Professional | None | $31.62 | $58.88 | $58.88 |
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 $16.98 Median $25.70 Typical High $31.62 | Professional | 52 · Reduced service | $16.98 | $25.70 | $31.62 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $6.92 Median $10.23 Typical High $12.59 | Professional | 53 · Discontinued | $6.92 | $10.23 | $12.59 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $5.13 Median $7.59 Typical High $9.33 | Professional | 55 · Aftercare only | $5.13 | $7.59 | $9.33 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $3.47 Median $5.13 Typical High $6.31 | Professional | 56 · Pre-op care only | $3.47 | $5.13 | $6.31 |
Where Florida sits
The same service costs 4.0 times more in Alaska than in Kentucky. 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· 49th of 51
$52.48
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.