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 $100.00 Median $107.15 Typical High $134.90 | Facility | None | $100.00 | $107.15 | $134.90 |
Aetna Setting Professional Modifier None Typical Low $97.72 Median $109.65 Typical High $138.04 | Professional | None | $97.72 | $109.65 | $138.04 |
Ambetter Setting Professional Modifier None Typical Low $112.20 Median $125.89 Typical High $141.25 | Professional | None | $112.20 | $125.89 | $141.25 |
AvMed Setting Facility Modifier None Typical Low $109.65 Median $138.04 Typical High $141.25 | Facility | None | $109.65 | $138.04 | $141.25 |
AvMed Setting Professional Modifier None Typical Low $100.00 Median $109.65 Typical High $138.04 | Professional | None | $100.00 | $109.65 | $138.04 |
Cigna Setting Facility Modifier None Typical Low $181.97 Median $181.97 Typical High $181.97 | Facility | None | $181.97 | $181.97 | $181.97 |
Cigna Setting Professional Modifier None Typical Low $89.13 Median $95.50 Typical High $158.49 | Professional | None | $89.13 | $95.50 | $158.49 |
Florida Blue Setting Professional Modifier None Typical Low $141.25 Median $141.25 Typical High $141.25 | Professional | None | $141.25 | $141.25 | $141.25 |
Molina Setting Professional Modifier None Typical Low $83.18 Median $85.11 Typical High $102.33 | Professional | None | $83.18 | $85.11 | $102.33 |
United Setting Professional Modifier None Typical Low $54.95 Median $107.15 Typical High $181.97 | Professional | None | $54.95 | $107.15 | $181.97 |
Wellpoint Setting Professional Modifier None Typical Low $102.33 Median $102.33 Typical High $131.83 | Professional | None | $102.33 | $102.33 | $131.83 |
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 $45.71 Median $52.48 Typical High $61.66 | Facility | 52 · Reduced service | $45.71 | $52.48 | $61.66 |
Aetna Setting Facility Modifier 55 · Aftercare only Typical Low $13.49 Median $15.85 Typical High $18.20 | Facility | 55 · Aftercare only | $13.49 | $15.85 | $18.20 |
Aetna Setting Facility Modifier 56 · Pre-op care only Typical Low $9.12 Median $10.47 Typical High $12.30 | Facility | 56 · Pre-op care only | $9.12 | $10.47 | $12.30 |
Aetna Setting Facility Modifier AF · Specialist physician Typical Low $120.23 Median $131.83 Typical High $138.04 | Facility | AF · Specialist physician | $120.23 | $131.83 | $138.04 |
Aetna Setting Facility Modifier HO · Master's level Typical Low $91.20 Median $97.72 Typical High $102.33 | Facility | HO · Master's level | $91.20 | $97.72 | $102.33 |
Aetna Setting Facility Modifier TD · Registered nurse Typical Low $102.33 Median $109.65 Typical High $117.49 | Facility | TD · Registered nurse | $102.33 | $109.65 | $117.49 |
Aetna Setting Professional Modifier 52 · Reduced service Typical Low $50.12 Median $52.48 Typical High $61.66 | Professional | 52 · Reduced service | $50.12 | $52.48 | $61.66 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $15.14 Median $15.85 Typical High $18.62 | Professional | 55 · Aftercare only | $15.14 | $15.85 | $18.62 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $10.00 Median $10.47 Typical High $12.30 | Professional | 56 · Pre-op care only | $10.00 | $10.47 | $12.30 |
Where Florida sits
The same service costs 2.1 times more in Wisconsin than in Ohio. 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· 38th of 51
$115
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.