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 $43.65 Median $54.95 Typical High $77.62 | Facility | None | $43.65 | $54.95 | $77.62 |
Aetna Setting Professional Modifier None Typical Low $52.48 Median $66.07 Typical High $97.72 | Professional | None | $52.48 | $66.07 | $97.72 |
Aetna Setting Professional Modifier 52 · Reduced service Typical Low $21.88 Median $31.62 Typical High $40.74 | Professional | 52 · Reduced service | $21.88 | $31.62 | $40.74 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $6.46 Median $9.55 Typical High $12.02 | Professional | 55 · Aftercare only | $6.46 | $9.55 | $12.02 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $4.37 Median $6.31 Typical High $8.13 | Professional | 56 · Pre-op care only | $4.37 | $6.31 | $8.13 |
Ambetter Setting Professional Modifier None Typical Low $81.28 Median $89.13 Typical High $112.20 | Professional | None | $81.28 | $89.13 | $112.20 |
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 $165.96 | Professional | None | $64.57 | $85.11 | $165.96 |
Cigna Setting Facility Modifier None Typical Low $83.18 Median $83.18 Typical High $83.18 | Facility | None | $83.18 | $83.18 | $83.18 |
Cigna Setting Professional Modifier None Typical Low $46.77 Median $67.61 Typical High $104.71 | Professional | None | $46.77 | $67.61 | $104.71 |
Florida Blue Setting Professional Modifier None Typical Low $35.48 Median $77.62 Typical High $109.65 | Professional | None | $35.48 | $77.62 | $109.65 |
Molina Setting Professional Modifier None Typical Low $53.70 Median $77.62 Typical High $104.71 | Professional | None | $53.70 | $77.62 | $104.71 |
United Setting Professional Modifier None Typical Low $42.66 Median $64.57 Typical High $107.15 | Professional | None | $42.66 | $64.57 | $107.15 |
Wellpoint Setting Professional Modifier None Typical Low $48.98 Median $70.79 Typical High $70.79 | Professional | None | $48.98 | $70.79 | $70.79 |
3 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 $87.10 Median $102.33 Typical High $104.71 | Professional | 25 · Same-day visit | $87.10 | $102.33 | $104.71 |
Ambetter Setting Professional Modifier EP · Child screening program Typical Low $89.13 Median $109.65 Typical High $138.04 | Professional | EP · Child screening program | $89.13 | $109.65 | $138.04 |
Ambetter Setting Professional Modifier SA · Nurse practitioner Typical Low $102.33 Median $102.33 Typical High $102.33 | Professional | SA · Nurse practitioner | $102.33 | $102.33 | $102.33 |
Where Florida sits
The same service costs 2.9 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· 49th of 51
$70.79
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.