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 $19.50 Median $21.88 Typical High $66.07 | Facility | None | $19.50 | $21.88 | $66.07 |
Aetna Setting Professional Modifier None Typical Low $19.50 Median $53.70 Typical High $75.86 | Professional | None | $19.50 | $53.70 | $75.86 |
Ambetter Setting Professional Modifier None Typical Low $21.38 Median $21.38 Typical High $25.12 | Professional | None | $21.38 | $21.38 | $25.12 |
AvMed Setting Facility Modifier None Typical Low $21.38 Median $51.29 Typical High $66.07 | Facility | None | $21.38 | $51.29 | $66.07 |
AvMed Setting Professional Modifier None Typical Low $21.88 Median $51.29 Typical High $66.07 | Professional | None | $21.88 | $51.29 | $66.07 |
Cigna Setting Facility Modifier None Typical Low $36.31 Median $36.31 Typical High $36.31 | Facility | None | $36.31 | $36.31 | $36.31 |
Cigna Setting Professional Modifier None Typical Low $17.78 Median $41.69 Typical High $104.71 | Professional | None | $17.78 | $41.69 | $104.71 |
Florida Blue Setting Professional Modifier None Typical Low $34.67 Median $69.18 Typical High $87.10 | Professional | None | $34.67 | $69.18 | $87.10 |
Molina Setting Professional Modifier None Typical Low $67.61 Median $144.54 Typical High $173.78 | Professional | None | $67.61 | $144.54 | $173.78 |
United Setting Professional Modifier None Typical Low $19.95 Median $53.70 Typical High $107.15 | Professional | None | $19.95 | $53.70 | $107.15 |
Wellpoint Setting Professional Modifier None Typical Low $16.22 Median $47.86 Typical High $47.86 | Professional | None | $16.22 | $47.86 | $47.86 |
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 $9.77 Median $26.92 Typical High $33.88 | Professional | 52 · Reduced service | $9.77 | $26.92 | $33.88 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $3.89 Median $10.72 Typical High $13.49 | Professional | 53 · Discontinued | $3.89 | $10.72 | $13.49 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $2.88 Median $7.94 Typical High $10.23 | Professional | 55 · Aftercare only | $2.88 | $7.94 | $10.23 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $1.95 Median $5.37 Typical High $6.92 | Professional | 56 · Pre-op care only | $1.95 | $5.37 | $6.92 |
Where Florida sits
The same service costs 4.4 times more in North Dakota 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· 21st of 51
$64.57
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.