How much rates vary
Facilitymedian $174 · 10th to 90th $141 to $240Professionalmedian $170 · 10th to 90th $135 to $240
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 $141.25 Median $169.82 Typical High $208.93 | Facility | None | $141.25 | $169.82 | $208.93 |
Aetna Setting Facility Modifier 52 · Reduced service Typical Low $67.61 Median $81.28 Typical High $95.50 | Facility | 52 · Reduced service | $67.61 | $81.28 | $95.50 |
Aetna Setting Facility Modifier 55 · Aftercare only Typical Low $20.42 Median $24.55 Typical High $28.18 | Facility | 55 · Aftercare only | $20.42 | $24.55 | $28.18 |
Aetna Setting Facility Modifier 56 · Pre-op care only Typical Low $13.49 Median $16.22 Typical High $19.05 | Facility | 56 · Pre-op care only | $13.49 | $16.22 | $19.05 |
Aetna Setting Professional Modifier None Typical Low $138.04 Median $173.78 Typical High $234.42 | Professional | None | $138.04 | $173.78 | $234.42 |
Aetna Setting Professional Modifier 52 · Reduced service Typical Low $70.79 Median $83.18 Typical High $97.72 | Professional | 52 · Reduced service | $70.79 | $83.18 | $97.72 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $21.38 Median $24.55 Typical High $29.51 | Professional | 55 · Aftercare only | $21.38 | $24.55 | $29.51 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $14.13 Median $16.60 Typical High $19.50 | Professional | 56 · Pre-op care only | $14.13 | $16.60 | $19.50 |
Ambetter Setting Professional Modifier None Typical Low $194.98 Median $269.15 Typical High $407.38 | Professional | None | $194.98 | $269.15 | $407.38 |
AvMed Setting Professional Modifier None Typical Low $186.21 Median $218.78 Typical High $239.88 | Professional | None | $186.21 | $218.78 | $239.88 |
Cigna Setting Facility Modifier None Typical Low $251.19 Median $251.19 Typical High $251.19 | Facility | None | $251.19 | $251.19 | $251.19 |
Cigna Setting Professional Modifier None Typical Low $125.89 Median $151.36 Typical High $257.04 | Professional | None | $125.89 | $151.36 | $257.04 |
Florida Blue Setting Facility Modifier None Typical Low $239.88 Median $239.88 Typical High $239.88 | Facility | None | $239.88 | $239.88 | $239.88 |
Florida Blue Setting Professional Modifier None Typical Low $107.15 Median $204.17 Typical High $245.47 | Professional | None | $107.15 | $204.17 | $245.47 |
Molina Setting Professional Modifier None Typical Low $144.54 Median $162.18 Typical High $251.19 | Professional | None | $144.54 | $162.18 | $251.19 |
United Setting Professional Modifier None Typical Low $123.03 Median $177.83 Typical High $263.03 | Professional | None | $123.03 | $177.83 | $263.03 |
Wellpoint Setting Professional Modifier None Typical Low $138.04 Median $162.18 Typical High $162.18 | Professional | None | $138.04 | $162.18 | $162.18 |
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 $204.17 Typical High $239.88 | Facility | AF · Specialist physician | $138.04 | $204.17 | $239.88 |
Aetna Setting Facility Modifier HO · Master's level Typical Low $138.04 Median $154.88 Typical High $177.83 | Facility | HO · Master's level | $138.04 | $154.88 | $177.83 |
Aetna Setting Facility Modifier TD · Registered nurse Typical Low $158.49 Median $173.78 Typical High $199.53 | Facility | TD · Registered nurse | $158.49 | $173.78 | $199.53 |
Ambetter Setting Professional Modifier 25 · Same-day visit Typical Low $204.17 Median $316.23 Typical High $371.54 | Professional | 25 · Same-day visit | $204.17 | $316.23 | $371.54 |
Where Florida sits
The same service costs 2.4 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· 48th of 51
$170
AK $380AL $158
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.