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 $123.03 Median $138.04 Typical High $173.78 | Facility | None | $123.03 | $138.04 | $173.78 |
Aetna Setting Professional Modifier None Typical Low $125.89 Median $147.91 Typical High $239.88 | Professional | None | $125.89 | $147.91 | $239.88 |
Ambetter Setting Professional Modifier None Typical Low $95.50 Median $138.04 Typical High $208.93 | Professional | None | $95.50 | $138.04 | $208.93 |
AvMed Setting Facility Modifier None Typical Low $154.88 Median $162.18 Typical High $165.96 | Facility | None | $154.88 | $162.18 | $165.96 |
AvMed Setting Professional Modifier None Typical Low $147.91 Median $162.18 Typical High $173.78 | Professional | None | $147.91 | $162.18 | $173.78 |
Cigna Setting Facility Modifier None Typical Low $190.55 Median $190.55 Typical High $190.55 | Facility | None | $190.55 | $190.55 | $190.55 |
Cigna Setting Professional Modifier None Typical Low $97.72 Median $125.89 Typical High $295.12 | Professional | None | $97.72 | $125.89 | $295.12 |
Florida Blue Setting Professional Modifier None Typical Low $70.79 Median $100.00 Typical High $151.36 | Professional | None | $70.79 | $100.00 | $151.36 |
Molina Setting Professional Modifier None Typical Low $107.15 Median $151.36 Typical High $288.40 | Professional | None | $107.15 | $151.36 | $288.40 |
United Setting Professional Modifier None Typical Low $112.20 Median $165.96 Typical High $323.59 | Professional | None | $112.20 | $165.96 | $323.59 |
Wellpoint Setting Professional Modifier None Typical Low $107.15 Median $107.15 Typical High $138.04 | Professional | None | $107.15 | $107.15 | $138.04 |
9 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 $60.26 Median $63.10 Typical High $75.86 | Facility | 52 · Reduced service | $60.26 | $63.10 | $75.86 |
Aetna Setting Facility Modifier 55 · Aftercare only Typical Low $17.78 Median $19.05 Typical High $22.91 | Facility | 55 · Aftercare only | $17.78 | $19.05 | $22.91 |
Aetna Setting Facility Modifier 56 · Pre-op care only Typical Low $12.02 Median $12.59 Typical High $15.14 | Facility | 56 · Pre-op care only | $12.02 | $12.59 | $15.14 |
Aetna Setting Facility Modifier AF · Specialist physician Typical Low $173.78 Median $173.78 Typical High $181.97 | Facility | AF · Specialist physician | $173.78 | $173.78 | $181.97 |
Aetna Setting Facility Modifier HO · Master's level Typical Low $128.82 Median $128.82 Typical High $131.83 | Facility | HO · Master's level | $128.82 | $128.82 | $131.83 |
Aetna Setting Facility Modifier TD · Registered nurse Typical Low $147.91 Median $147.91 Typical High $147.91 | Facility | TD · Registered nurse | $147.91 | $147.91 | $147.91 |
Aetna Setting Professional Modifier 52 · Reduced service Typical Low $60.26 Median $63.10 Typical High $79.43 | Professional | 52 · Reduced service | $60.26 | $63.10 | $79.43 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $17.78 Median $19.05 Typical High $23.99 | Professional | 55 · Aftercare only | $17.78 | $19.05 | $23.99 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $12.02 Median $12.59 Typical High $16.22 | Professional | 56 · Pre-op care only | $12.02 | $12.59 | $16.22 |
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· 44th of 51
$148
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.