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 $7.24 Median $8.13 Typical High $15.85 | Facility | None | $7.24 | $8.13 | $15.85 |
Aetna Setting Professional Modifier None Typical Low $7.94 Median $13.18 Typical High $19.05 | Professional | None | $7.94 | $13.18 | $19.05 |
AvMed Setting Facility Modifier None Typical Low $14.45 Median $1,584.89 Typical High $4,466.84 | Facility | None | $14.45 | $1,584.89 | $4,466.84 |
AvMed Setting Professional Modifier None Typical Low $8.32 Median $15.14 Typical High $18.62 | Professional | None | $8.32 | $15.14 | $18.62 |
Cigna Setting Facility Modifier None Typical Low $13.80 Median $13.80 Typical High $13.80 | Facility | None | $13.80 | $13.80 | $13.80 |
Cigna Setting Professional Modifier None Typical Low $6.31 Median $12.88 Typical High $27.54 | Professional | None | $6.31 | $12.88 | $27.54 |
Florida Blue Setting Facility Modifier None Typical Low $32.36 Median $53.70 Typical High $97.72 | Facility | None | $32.36 | $53.70 | $97.72 |
Florida Blue Setting Professional Modifier None Typical Low $12.59 Median $13.18 Typical High $30.90 | Professional | None | $12.59 | $13.18 | $30.90 |
Molina Setting Professional Modifier None Typical Low $23.44 Median $23.44 Typical High $27.54 | Professional | None | $23.44 | $23.44 | $27.54 |
United Setting Professional Modifier None Typical Low $8.13 Median $16.98 Typical High $40.74 | Professional | None | $8.13 | $16.98 | $40.74 |
Wellpoint Setting Professional Modifier None Typical Low $7.76 Median $18.20 Typical High $18.20 | Professional | None | $7.76 | $18.20 | $18.20 |
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 $3.98 Median $6.61 Typical High $9.33 | Professional | 52 · Reduced service | $3.98 | $6.61 | $9.33 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $1.58 Median $2.63 Typical High $3.72 | Professional | 53 · Discontinued | $1.58 | $2.63 | $3.72 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $1.20 Median $2.00 Typical High $2.82 | Professional | 55 · Aftercare only | $1.20 | $2.00 | $2.82 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $0.79 Median $1.32 Typical High $1.86 | Professional | 56 · Pre-op care only | $0.79 | $1.32 | $1.86 |
Where Florida sits
The same service costs 3.2 times more in Wisconsin than in Nebraska. 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· 29th of 51
$18.20
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.