How much rates vary
Distribution of negotiated rates across all payers (price axis is log-scale). Small sample; interpret with caution. 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 $57.54 Median $67.61 Typical High $93.33 | Facility | None | $57.54 | $67.61 | $93.33 |
Aetna Setting Professional Modifier None Typical Low $64.57 Median $85.11 Typical High $123.03 | Professional | None | $64.57 | $85.11 | $123.03 |
Aetna Setting Professional Modifier 52 · Reduced service Typical Low $28.84 Median $40.74 Typical High $50.12 | Professional | 52 · Reduced service | $28.84 | $40.74 | $50.12 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $8.71 Median $12.30 Typical High $15.14 | Professional | 55 · Aftercare only | $8.71 | $12.30 | $15.14 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $5.75 Median $8.13 Typical High $10.00 | Professional | 56 · Pre-op care only | $5.75 | $8.13 | $10.00 |
Ambetter Setting Professional Modifier None Typical Low $123.03 Median $123.03 Typical High $128.82 | Professional | None | $123.03 | $123.03 | $128.82 |
AvMed Setting Facility Modifier None Typical Low $64.57 Median $64.57 Typical High $64.57 | Facility | None | $64.57 | $64.57 | $64.57 |
AvMed Setting Professional Modifier None Typical Low $64.57 Median $85.11 Typical High $169.82 | Professional | None | $64.57 | $85.11 | $169.82 |
Cigna Setting Facility Modifier None Typical Low $102.33 Median $102.33 Typical High $102.33 | Facility | None | $102.33 | $102.33 | $102.33 |
Cigna Setting Professional Modifier None Typical Low $58.88 Median $81.28 Typical High $131.83 | Professional | None | $58.88 | $81.28 | $131.83 |
Florida Blue Setting Professional Modifier None Typical Low $45.71 Median $97.72 Typical High $131.83 | Professional | None | $45.71 | $97.72 | $131.83 |
Molina Setting Professional Modifier None Typical Low $67.61 Median $95.50 Typical High $131.83 | Professional | None | $67.61 | $95.50 | $131.83 |
United Setting Professional Modifier None Typical Low $54.95 Median $83.18 Typical High $131.83 | Professional | None | $54.95 | $83.18 | $131.83 |
Wellpoint Setting Professional Modifier None Typical Low $58.88 Median $75.86 Typical High $75.86 | Professional | None | $58.88 | $75.86 | $75.86 |
2 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 |
|---|---|---|---|---|---|
Ambetter Setting Professional Modifier 25 · Same-day visit Typical Low $104.71 Median $123.03 Typical High $134.90 | Professional | 25 · Same-day visit | $104.71 | $123.03 | $134.90 |
Ambetter Setting Professional Modifier EP · Child screening program Typical Low $97.72 Median $131.83 Typical High $131.83 | Professional | EP · Child screening program | $97.72 | $131.83 | $131.83 |
Where Florida sits
The same service costs 2.8 times more in Alaska than in Washington, DC. 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· 50th of 51
$83.18
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.