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 $91.20 | Facility | None | $57.54 | $67.61 | $91.20 |
Aetna Setting Professional Modifier None Typical Low $64.57 Median $85.11 Typical High $117.49 | Professional | None | $64.57 | $85.11 | $117.49 |
Aetna Setting Professional Modifier 52 · Reduced service Typical Low $28.84 Median $38.90 Typical High $48.98 | Professional | 52 · Reduced service | $28.84 | $38.90 | $48.98 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $8.71 Median $11.75 Typical High $14.79 | Professional | 55 · Aftercare only | $8.71 | $11.75 | $14.79 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $5.75 Median $7.76 Typical High $9.77 | Professional | 56 · Pre-op care only | $5.75 | $7.76 | $9.77 |
Ambetter Setting Professional Modifier None Typical Low $95.50 Median $117.49 Typical High $123.03 | Professional | None | $95.50 | $117.49 | $123.03 |
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 $95.50 Typical High $169.82 | Professional | None | $64.57 | $95.50 | $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 $79.43 Typical High $125.89 | Professional | None | $58.88 | $79.43 | $125.89 |
Florida Blue Setting Professional Modifier None Typical Low $43.65 Median $95.50 Typical High $128.82 | Professional | None | $43.65 | $95.50 | $128.82 |
Molina Setting Professional Modifier None Typical Low $64.57 Median $95.50 Typical High $128.82 | Professional | None | $64.57 | $95.50 | $128.82 |
United Setting Professional Modifier None Typical Low $54.95 Median $79.43 Typical High $125.89 | Professional | None | $54.95 | $79.43 | $125.89 |
Wellpoint Setting Professional Modifier None Typical Low $58.88 Median $70.79 Typical High $70.79 | Professional | None | $58.88 | $70.79 | $70.79 |
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 $100.00 Median $117.49 Typical High $123.03 | Professional | 25 · Same-day visit | $100.00 | $117.49 | $123.03 |
Ambetter Setting Professional Modifier EP · Child screening program Typical Low $109.65 Median $117.49 Typical High $213.80 | Professional | EP · Child screening program | $109.65 | $117.49 | $213.80 |
Where Florida sits
The same service costs 2.7 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
$81.28
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.