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 $4.47 Median $4.68 Typical High $5.37 | Facility | None | $4.47 | $4.68 | $5.37 |
Aetna Setting Professional Modifier None Typical Low $4.47 Median $4.68 Typical High $5.89 | Professional | None | $4.47 | $4.68 | $5.89 |
Aetna Setting Professional Modifier 52 · Reduced service Typical Low $2.24 Median $2.34 Typical High $2.69 | Professional | 52 · Reduced service | $2.24 | $2.34 | $2.69 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $0.89 Median $0.93 Typical High $1.07 | Professional | 53 · Discontinued | $0.89 | $0.93 | $1.07 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $0.68 Median $0.71 Typical High $0.81 | Professional | 55 · Aftercare only | $0.68 | $0.71 | $0.81 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $0.45 Median $0.47 Typical High $0.54 | Professional | 56 · Pre-op care only | $0.45 | $0.47 | $0.54 |
Ambetter Setting Professional Modifier None Typical Low $3.72 Median $4.27 Typical High $5.37 | Professional | None | $3.72 | $4.27 | $5.37 |
AvMed Setting Facility Modifier None Typical Low $4.27 Median $5.37 Typical High $5.75 | Facility | None | $4.27 | $5.37 | $5.75 |
AvMed Setting Professional Modifier None Typical Low $3.98 Median $5.01 Typical High $5.75 | Professional | None | $3.98 | $5.01 | $5.75 |
Cigna Setting Facility Modifier None Typical Low $7.76 Median $7.76 Typical High $7.76 | Facility | None | $7.76 | $7.76 | $7.76 |
Cigna Setting Professional Modifier None Typical Low $3.02 Median $3.98 Typical High $6.03 | Professional | None | $3.02 | $3.98 | $6.03 |
Florida Blue Setting Professional Modifier None Typical Low $3.47 Median $3.47 Typical High $4.27 | Professional | None | $3.47 | $3.47 | $4.27 |
Molina Setting Professional Modifier None Typical Low $6.31 Median $39.81 Typical High $39.81 | Professional | None | $6.31 | $39.81 | $39.81 |
United Setting Facility Modifier None Typical Low $43.65 Median $46.77 Typical High $46.77 | Facility | None | $43.65 | $46.77 | $46.77 |
United Setting Professional Modifier None Typical Low $3.72 Median $5.13 Typical High $9.77 | Professional | None | $3.72 | $5.13 | $9.77 |
Wellpoint Setting Professional Modifier None Typical Low $5.01 Median $5.01 Typical High $5.01 | Professional | None | $5.01 | $5.01 | $5.01 |
3 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 |
|---|---|---|---|---|---|
Ambetter Setting Professional Modifier 51 · Multiple procedures Typical Low $5.75 Median $5.75 Typical High $5.75 | Professional | 51 · Multiple procedures | $5.75 | $5.75 | $5.75 |
Ambetter Setting Professional Modifier 59 · Distinct service Typical Low $4.07 Median $4.90 Typical High $5.50 | Professional | 59 · Distinct service | $4.07 | $4.90 | $5.50 |
Ambetter Setting Professional Modifier XU · Unusual separate service Typical Low $5.13 Median $5.13 Typical High $5.13 | Professional | XU · Unusual separate service | $5.13 | $5.13 | $5.13 |
Where Florida sits
The same service costs 2.7 times more in North Dakota than in New Mexico. 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· 37th of 51
$4.68
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.