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 $91.20 Median $97.72 Typical High $6,760.83 | Facility | None | $91.20 | $97.72 | $6,760.83 |
Aetna Setting Professional Modifier None Typical Low $89.13 Median $95.50 Typical High $125.89 | Professional | None | $89.13 | $95.50 | $125.89 |
Ambetter Setting Professional Modifier None Typical Low $102.33 Median $102.33 Typical High $102.33 | Professional | None | $102.33 | $102.33 | $102.33 |
AvMed Setting Facility Modifier None Typical Low $102.33 Median $2,137.96 Typical High $11,748.98 | Facility | None | $102.33 | $2,137.96 | $11,748.98 |
AvMed Setting Professional Modifier None Typical Low $87.10 Median $109.65 Typical High $134.90 | Professional | None | $87.10 | $109.65 | $134.90 |
Cigna Setting Facility Modifier None Typical Low $331.13 Median $1,659.59 Typical High $3,090.30 | Facility | None | $331.13 | $1,659.59 | $3,090.30 |
Cigna Setting Professional Modifier None Typical Low $77.62 Median $109.65 Typical High $208.93 | Professional | None | $77.62 | $109.65 | $208.93 |
Florida Blue Setting Facility Modifier None Typical Low $891.25 Median $1,737.80 Typical High $16,982.44 | Facility | None | $891.25 | $1,737.80 | $16,982.44 |
Florida Blue Setting Professional Modifier None Typical Low $72.44 Median $77.62 Typical High $131.83 | Professional | None | $72.44 | $77.62 | $131.83 |
Molina Setting Professional Modifier None Typical Low $112.20 Median $162.18 Typical High $288.40 | Professional | None | $112.20 | $162.18 | $288.40 |
United Setting Facility Modifier None Typical Low $794.33 Median $1,778.28 Typical High $7,585.78 | Facility | None | $794.33 | $1,778.28 | $7,585.78 |
United Setting Professional Modifier None Typical Low $60.26 Median $117.49 Typical High $223.87 | Professional | None | $60.26 | $117.49 | $223.87 |
Wellpoint Setting Professional Modifier None Typical Low $72.44 Median $72.44 Typical High $102.33 | Professional | None | $72.44 | $72.44 | $102.33 |
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 $44.67 Median $47.86 Typical High $56.23 | Professional | 52 · Reduced service | $44.67 | $47.86 | $56.23 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $17.78 Median $19.05 Typical High $22.39 | Professional | 53 · Discontinued | $17.78 | $19.05 | $22.39 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $13.49 Median $14.13 Typical High $16.98 | Professional | 55 · Aftercare only | $13.49 | $14.13 | $16.98 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $8.91 Median $9.55 Typical High $11.22 | Professional | 56 · Pre-op care only | $8.91 | $9.55 | $11.22 |
Where Florida sits
The same service costs 7.9 times more in Kansas than in New York. 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· 6th of 51
$302
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.