How much rates vary
Facilitymedian $186 · 10th to 90th $170 to $224Professionalmedian $191 · 10th to 90th $148 to $347
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 $173.78 Median $186.21 Typical High $229.09 | Facility | None | $173.78 | $186.21 | $229.09 |
Aetna Setting Professional Modifier None Typical Low $147.91 Median $186.21 Typical High $288.40 | Professional | None | $147.91 | $186.21 | $288.40 |
Ambetter Setting Professional Modifier None Typical Low $158.49 Median $194.98 Typical High $371.54 | Professional | None | $158.49 | $194.98 | $371.54 |
AvMed Setting Facility Modifier None Typical Low $158.49 Median $199.53 Typical High $208.93 | Facility | None | $158.49 | $199.53 | $208.93 |
AvMed Setting Professional Modifier None Typical Low $158.49 Median $208.93 Typical High $234.42 | Professional | None | $158.49 | $208.93 | $234.42 |
Cigna Setting Facility Modifier None Typical Low $269.15 Median $269.15 Typical High $269.15 | Facility | None | $269.15 | $269.15 | $269.15 |
Cigna Setting Professional Modifier None Typical Low $147.91 Median $190.55 Typical High $398.11 | Professional | None | $147.91 | $190.55 | $398.11 |
Florida Blue Setting Professional Modifier None Typical Low $134.90 Median $154.88 Typical High $208.93 | Professional | None | $134.90 | $154.88 | $208.93 |
Molina Setting Professional Modifier None Typical Low $131.83 Median $190.55 Typical High $354.81 | Professional | None | $131.83 | $190.55 | $354.81 |
United Setting Professional Modifier None Typical Low $147.91 Median $218.78 Typical High $426.58 | Professional | None | $147.91 | $218.78 | $426.58 |
Wellpoint Setting Professional Modifier None Typical Low $147.91 Median $147.91 Typical High $194.98 | Professional | None | $147.91 | $147.91 | $194.98 |
10 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 Facility Modifier 52 · Reduced service Typical Low $87.10 Median $89.13 Typical High $104.71 | Facility | 52 · Reduced service | $87.10 | $89.13 | $104.71 |
Aetna Setting Facility Modifier 55 · Aftercare only Typical Low $26.30 Median $26.92 Typical High $31.62 | Facility | 55 · Aftercare only | $26.30 | $26.92 | $31.62 |
Aetna Setting Facility Modifier 56 · Pre-op care only Typical Low $17.38 Median $18.62 Typical High $20.89 | Facility | 56 · Pre-op care only | $17.38 | $18.62 | $20.89 |
Aetna Setting Facility Modifier AF · Specialist physician Typical Low $60.26 Median $199.53 Typical High $234.42 | Facility | AF · Specialist physician | $60.26 | $199.53 | $234.42 |
Aetna Setting Facility Modifier HO · Master's level Typical Low $144.54 Median $147.91 Typical High $173.78 | Facility | HO · Master's level | $144.54 | $147.91 | $173.78 |
Aetna Setting Facility Modifier TD · Registered nurse Typical Low $162.18 Median $169.82 Typical High $199.53 | Facility | TD · Registered nurse | $162.18 | $169.82 | $199.53 |
Aetna Setting Professional Modifier 52 · Reduced service Typical Low $83.18 Median $89.13 Typical High $104.71 | Professional | 52 · Reduced service | $83.18 | $89.13 | $104.71 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $25.12 Median $26.92 Typical High $31.62 | Professional | 55 · Aftercare only | $25.12 | $26.92 | $31.62 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $16.98 Median $17.78 Typical High $20.89 | Professional | 56 · Pre-op care only | $16.98 | $17.78 | $20.89 |
Ambetter Setting Professional Modifier FS · Shared visit Typical Low $194.98 Median $194.98 Typical High $436.52 | Professional | FS · Shared visit | $194.98 | $194.98 | $436.52 |
Where Florida sits
The same service costs 2.4 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· 47th of 51
$191
AK $407UT $170
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.