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 $70.79 Typical High $93.33 | Facility | None | $57.54 | $70.79 | $93.33 |
Aetna Setting Professional Modifier None Typical Low $66.07 Median $87.10 Typical High $120.23 | Professional | None | $66.07 | $87.10 | $120.23 |
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 $97.72 Median $112.20 Typical High $128.82 | Professional | None | $97.72 | $112.20 | $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 $104.71 Median $104.71 Typical High $104.71 | Facility | None | $104.71 | $104.71 | $104.71 |
Cigna Setting Professional Modifier None Typical Low $60.26 Median $81.28 Typical High $128.82 | Professional | None | $60.26 | $81.28 | $128.82 |
Florida Blue Setting Professional Modifier None Typical Low $43.65 Median $95.50 Typical High $131.83 | Professional | None | $43.65 | $95.50 | $131.83 |
Molina Setting Professional Modifier None Typical Low $66.07 Median $104.71 Typical High $194.98 | Professional | None | $66.07 | $104.71 | $194.98 |
United Setting Professional Modifier None Typical Low $54.95 Median $81.28 Typical High $128.82 | Professional | None | $54.95 | $81.28 | $128.82 |
Wellpoint Setting Professional Modifier None Typical Low $58.88 Median $95.50 Typical High $95.50 | Professional | None | $58.88 | $95.50 | $95.50 |
6 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 $79.43 Median $109.65 Typical High $128.82 | Professional | 25 · Same-day visit | $79.43 | $109.65 | $128.82 |
Ambetter Setting Professional Modifier 33 · Preventive service Typical Low $128.82 Median $128.82 Typical High $128.82 | Professional | 33 · Preventive service | $128.82 | $128.82 | $128.82 |
Ambetter Setting Professional Modifier 57 · Decision for surgery Typical Low $100.00 Median $100.00 Typical High $100.00 | Professional | 57 · Decision for surgery | $100.00 | $100.00 | $100.00 |
Ambetter Setting Professional Modifier EP · Child screening program Typical Low $102.33 Median $125.89 Typical High $144.54 | Professional | EP · Child screening program | $102.33 | $125.89 | $144.54 |
Ambetter Setting Professional Modifier GY · Excluded by law Typical Low $25.12 Median $25.12 Typical High $25.12 | Professional | GY · Excluded by law | $25.12 | $25.12 | $25.12 |
Wellpoint Setting Professional Modifier EP · Child screening program Typical Low $60.26 Median $60.26 Typical High $70.79 | Professional | EP · Child screening program | $60.26 | $60.26 | $70.79 |
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· 48th of 51
$87.10
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.