How much rates vary
Facilitymedian $138 · 10th to 90th $115 to $191Professionalmedian $138 · 10th to 90th $105 to $195
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 $114.82 Median $138.04 Typical High $169.82 | Facility | None | $114.82 | $138.04 | $169.82 |
Aetna Setting Facility Modifier 52 · Reduced service Typical Low $54.95 Median $66.07 Typical High $77.62 | Facility | 52 · Reduced service | $54.95 | $66.07 | $77.62 |
Aetna Setting Facility Modifier 55 · Aftercare only Typical Low $16.60 Median $19.50 Typical High $23.44 | Facility | 55 · Aftercare only | $16.60 | $19.50 | $23.44 |
Aetna Setting Facility Modifier 56 · Pre-op care only Typical Low $10.96 Median $13.18 Typical High $15.49 | Facility | 56 · Pre-op care only | $10.96 | $13.18 | $15.49 |
Aetna Setting Professional Modifier None Typical Low $112.20 Median $141.25 Typical High $190.55 | Professional | None | $112.20 | $141.25 | $190.55 |
Aetna Setting Professional Modifier 52 · Reduced service Typical Low $57.54 Median $66.07 Typical High $77.62 | Professional | 52 · Reduced service | $57.54 | $66.07 | $77.62 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $16.98 Median $20.42 Typical High $23.44 | Professional | 55 · Aftercare only | $16.98 | $20.42 | $23.44 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $11.48 Median $13.49 Typical High $15.49 | Professional | 56 · Pre-op care only | $11.48 | $13.49 | $15.49 |
Ambetter Setting Professional Modifier None Typical Low $158.49 Median $173.78 Typical High $239.88 | Professional | None | $158.49 | $173.78 | $239.88 |
AvMed Setting Professional Modifier None Typical Low $144.54 Median $169.82 Typical High $194.98 | Professional | None | $144.54 | $169.82 | $194.98 |
Cigna Setting Facility Modifier None Typical Low $186.21 Median $186.21 Typical High $186.21 | Facility | None | $186.21 | $186.21 | $186.21 |
Cigna Setting Professional Modifier None Typical Low $95.50 Median $117.49 Typical High $204.17 | Professional | None | $95.50 | $117.49 | $204.17 |
Florida Blue Setting Facility Modifier None Typical Low $190.55 Median $190.55 Typical High $190.55 | Facility | None | $190.55 | $190.55 | $190.55 |
Florida Blue Setting Professional Modifier None Typical Low $87.10 Median $158.49 Typical High $194.98 | Professional | None | $87.10 | $158.49 | $194.98 |
Molina Setting Professional Modifier None Typical Low $114.82 Median $138.04 Typical High $346.74 | Professional | None | $114.82 | $138.04 | $346.74 |
United Setting Professional Modifier None Typical Low $97.72 Median $144.54 Typical High $213.80 | Professional | None | $97.72 | $144.54 | $213.80 |
Wellpoint Setting Professional Modifier None Typical Low $104.71 Median $125.89 Typical High $125.89 | Professional | None | $104.71 | $125.89 | $125.89 |
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 Facility Modifier AF · Specialist physician Typical Low $138.04 Median $169.82 Typical High $194.98 | Facility | AF · Specialist physician | $138.04 | $169.82 | $194.98 |
Aetna Setting Facility Modifier HO · Master's level Typical Low $112.20 Median $125.89 Typical High $144.54 | Facility | HO · Master's level | $112.20 | $125.89 | $144.54 |
Aetna Setting Facility Modifier TD · Registered nurse Typical Low $128.82 Median $144.54 Typical High $165.96 | Facility | TD · Registered nurse | $128.82 | $144.54 | $165.96 |
Ambetter Setting Professional Modifier 25 · Same-day visit Typical Low $158.49 Median $165.96 Typical High $281.84 | Professional | 25 · Same-day visit | $158.49 | $165.96 | $281.84 |
Where Florida sits
The same service costs 2.3 times more in Alaska than in Alabama. 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· 45th of 51
$138
AK $288AL $123
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.