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 $67.61 Median $70.79 Typical High $87.10 | Facility | None | $67.61 | $70.79 | $87.10 |
Aetna Setting Professional Modifier None Typical Low $64.57 Median $74.13 Typical High $89.13 | Professional | None | $64.57 | $74.13 | $89.13 |
Ambetter Setting Professional Modifier None Typical Low $58.88 Median $79.43 Typical High $81.28 | Professional | None | $58.88 | $79.43 | $81.28 |
AvMed Setting Facility Modifier None Typical Low $64.57 Median $81.28 Typical High $83.18 | Facility | None | $64.57 | $81.28 | $83.18 |
AvMed Setting Professional Modifier None Typical Low $58.88 Median $64.57 Typical High $81.28 | Professional | None | $58.88 | $64.57 | $81.28 |
Cigna Setting Facility Modifier None Typical Low $109.65 Median $109.65 Typical High $109.65 | Facility | None | $109.65 | $109.65 | $109.65 |
Cigna Setting Professional Modifier None Typical Low $53.70 Median $58.88 Typical High $104.71 | Professional | None | $53.70 | $58.88 | $104.71 |
Florida Blue Setting Professional Modifier None Typical Low $83.18 Median $83.18 Typical High $83.18 | Professional | None | $83.18 | $83.18 | $83.18 |
Molina Setting Professional Modifier None Typical Low $58.88 Median $85.11 Typical High $87.10 | Professional | None | $58.88 | $85.11 | $87.10 |
United Setting Professional Modifier None Typical Low $39.81 Median $70.79 Typical High $120.23 | Professional | None | $39.81 | $70.79 | $120.23 |
Wellpoint Setting Professional Modifier None Typical Low $61.66 Median $61.66 Typical High $79.43 | Professional | None | $61.66 | $61.66 | $79.43 |
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 $30.20 Median $34.67 Typical High $39.81 | Facility | 52 · Reduced service | $30.20 | $34.67 | $39.81 |
Aetna Setting Facility Modifier 55 · Aftercare only Typical Low $9.12 Median $10.23 Typical High $12.02 | Facility | 55 · Aftercare only | $9.12 | $10.23 | $12.02 |
Aetna Setting Facility Modifier 56 · Pre-op care only Typical Low $6.03 Median $6.92 Typical High $7.94 | Facility | 56 · Pre-op care only | $6.03 | $6.92 | $7.94 |
Aetna Setting Facility Modifier AF · Specialist physician Typical Low $81.28 Median $87.10 Typical High $91.20 | Facility | AF · Specialist physician | $81.28 | $87.10 | $91.20 |
Aetna Setting Facility Modifier HO · Master's level Typical Low $60.26 Median $66.07 Typical High $67.61 | Facility | HO · Master's level | $60.26 | $66.07 | $67.61 |
Aetna Setting Facility Modifier TD · Registered nurse Typical Low $69.18 Median $74.13 Typical High $77.62 | Facility | TD · Registered nurse | $69.18 | $74.13 | $77.62 |
Aetna Setting Professional Modifier 52 · Reduced service Typical Low $33.11 Median $34.67 Typical High $40.74 | Professional | 52 · Reduced service | $33.11 | $34.67 | $40.74 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $10.00 Median $10.23 Typical High $12.02 | Professional | 55 · Aftercare only | $10.00 | $10.23 | $12.02 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $6.61 Median $6.92 Typical High $8.13 | Professional | 56 · Pre-op care only | $6.61 | $6.92 | $8.13 |
Where Florida sits
The same service costs 2.1 times more in Oregon 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· 40th of 51
$74.13
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.