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 $13.18 Median $58.88 Typical High $588.84 | Facility | None | $13.18 | $58.88 | $588.84 |
Aetna Setting Professional Modifier None Typical Low $13.18 Median $35.48 Typical High $75.86 | Professional | None | $13.18 | $35.48 | $75.86 |
Ambetter Setting Professional Modifier None Typical Low $70.79 Median $70.79 Typical High $70.79 | Professional | None | $70.79 | $70.79 | $70.79 |
AvMed Setting Facility Modifier None Typical Low $60.26 Median $2,137.96 Typical High $11,748.98 | Facility | None | $60.26 | $2,137.96 | $11,748.98 |
AvMed Setting Professional Modifier None Typical Low $13.80 Median $60.26 Typical High $81.28 | Professional | None | $13.80 | $60.26 | $81.28 |
Cigna Setting Facility Modifier None Typical Low $56.23 Median $74.13 Typical High $537.03 | Facility | None | $56.23 | $74.13 | $537.03 |
Cigna Setting Professional Modifier None Typical Low $11.22 Median $47.86 Typical High $87.10 | Professional | None | $11.22 | $47.86 | $87.10 |
Florida Blue Setting Facility Modifier None Typical Low $34.67 Median $67.61 Typical High $2,187.76 | Facility | None | $34.67 | $67.61 | $2,187.76 |
Florida Blue Setting Professional Modifier None Typical Low $28.18 Median $63.10 Typical High $77.62 | Professional | None | $28.18 | $63.10 | $77.62 |
Molina Setting Professional Modifier None Typical Low $11.75 Median $56.23 Typical High $97.72 | Professional | None | $11.75 | $56.23 | $97.72 |
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 $11.75 Median $48.98 Typical High $97.72 | Professional | None | $11.75 | $48.98 | $97.72 |
Wellpoint Setting Professional Modifier None Typical Low $10.72 Median $57.54 Typical High $57.54 | Professional | None | $10.72 | $57.54 | $57.54 |
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 $6.61 Median $17.78 Typical High $35.48 | Professional | 52 · Reduced service | $6.61 | $17.78 | $35.48 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $2.63 Median $11.48 Typical High $14.13 | Professional | 53 · Discontinued | $2.63 | $11.48 | $14.13 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $1.95 Median $8.71 Typical High $10.47 | Professional | 55 · Aftercare only | $1.95 | $8.71 | $10.47 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $1.32 Median $5.75 Typical High $7.08 | Professional | 56 · Pre-op care only | $1.32 | $5.75 | $7.08 |
Where Florida sits
The same service costs 5.9 times more in Iowa 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· 36th of 51
$57.54
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.