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 $75.86 Median $75.86 Typical High $85.11 | Facility | None | $75.86 | $75.86 | $85.11 |
Aetna Setting Professional Modifier None Typical Low $75.86 Median $81.28 Typical High $102.33 | Professional | None | $75.86 | $81.28 | $102.33 |
Aetna Setting Professional Modifier 52 · Reduced service Typical Low $38.02 Median $40.74 Typical High $48.98 | Professional | 52 · Reduced service | $38.02 | $40.74 | $48.98 |
Ambetter Setting Professional Modifier None Typical Low $147.91 Median $147.91 Typical High $165.96 | Professional | None | $147.91 | $147.91 | $165.96 |
AvMed Setting Facility Modifier None Typical Low $70.79 Median $89.13 Typical High $93.33 | Facility | None | $70.79 | $89.13 | $93.33 |
AvMed Setting Professional Modifier None Typical Low $67.61 Median $87.10 Typical High $93.33 | Professional | None | $67.61 | $87.10 | $93.33 |
Cigna Setting Facility Modifier None Typical Low $138.04 Median $138.04 Typical High $138.04 | Facility | None | $138.04 | $138.04 | $138.04 |
Cigna Setting Professional Modifier None Typical Low $58.88 Median $97.72 Typical High $165.96 | Professional | None | $58.88 | $97.72 | $165.96 |
Florida Blue Setting Professional Modifier None Typical Low $48.98 Median $89.13 Typical High $109.65 | Professional | None | $48.98 | $89.13 | $109.65 |
Molina Setting Professional Modifier None Typical Low $74.13 Median $147.91 Typical High $177.83 | Professional | None | $74.13 | $147.91 | $177.83 |
United Setting Professional Modifier None Typical Low $67.61 Median $93.33 Typical High $173.78 | Professional | None | $67.61 | $93.33 | $173.78 |
Wellpoint Setting Professional Modifier None Typical Low $63.10 Median $63.10 Typical High $81.28 | Professional | None | $63.10 | $63.10 | $81.28 |
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 |
|---|---|---|---|---|---|
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $15.14 Median $16.22 Typical High $19.95 | Professional | 53 · Discontinued | $15.14 | $16.22 | $19.95 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $11.22 Median $12.30 Typical High $14.45 | Professional | 55 · Aftercare only | $11.22 | $12.30 | $14.45 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $7.59 Median $8.13 Typical High $9.77 | Professional | 56 · Pre-op care only | $7.59 | $8.13 | $9.77 |
Where Florida sits
The same service costs 2.9 times more in Alaska than in Utah. 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· 34th of 51
$93.33
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.