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 $56.23 Median $61.66 Typical High $72.44 | Facility | None | $56.23 | $61.66 | $72.44 |
Aetna Setting Professional Modifier None Typical Low $58.88 Median $67.61 Typical High $89.13 | Professional | None | $58.88 | $67.61 | $89.13 |
Aetna Setting Professional Modifier 52 · Reduced service Typical Low $29.51 Median $33.88 Typical High $38.90 | Professional | 52 · Reduced service | $29.51 | $33.88 | $38.90 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $8.91 Median $10.23 Typical High $11.48 | Professional | 55 · Aftercare only | $8.91 | $10.23 | $11.48 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $5.89 Median $6.76 Typical High $7.76 | Professional | 56 · Pre-op care only | $5.89 | $6.76 | $7.76 |
Ambetter Setting Professional Modifier None Typical Low $63.10 Median $87.10 Typical High $93.33 | Professional | None | $63.10 | $87.10 | $93.33 |
AvMed Setting Facility Modifier None Typical Low $69.18 Median $72.44 Typical High $74.13 | Facility | None | $69.18 | $72.44 | $74.13 |
AvMed Setting Professional Modifier None Typical Low $69.18 Median $72.44 Typical High $74.13 | Professional | None | $69.18 | $72.44 | $74.13 |
Cigna Setting Facility Modifier None Typical Low $87.10 Median $87.10 Typical High $87.10 | Facility | None | $87.10 | $87.10 | $87.10 |
Cigna Setting Professional Modifier None Typical Low $51.29 Median $63.10 Typical High $102.33 | Professional | None | $51.29 | $63.10 | $102.33 |
Florida Blue Setting Professional Modifier None Typical Low $39.81 Median $83.18 Typical High $104.71 | Professional | None | $39.81 | $83.18 | $104.71 |
Molina Setting Professional Modifier None Typical Low $51.29 Median $60.26 Typical High $100.00 | Professional | None | $51.29 | $60.26 | $100.00 |
United Setting Professional Modifier None Typical Low $52.48 Median $67.61 Typical High $104.71 | Professional | None | $52.48 | $67.61 | $104.71 |
Wellpoint Setting Professional Modifier None Typical Low $61.66 Median $87.10 Typical High $89.13 | Professional | None | $61.66 | $87.10 | $89.13 |
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 $60.26 Median $87.10 Typical High $91.20 | Professional | 25 · Same-day visit | $60.26 | $87.10 | $91.20 |
Ambetter Setting Professional Modifier 33 · Preventive service Typical Low $74.13 Median $74.13 Typical High $87.10 | Professional | 33 · Preventive service | $74.13 | $74.13 | $87.10 |
Ambetter Setting Professional Modifier FP · Family planning Typical Low $87.10 Median $87.10 Typical High $93.33 | Professional | FP · Family planning | $87.10 | $87.10 | $93.33 |
Where Florida sits
The same service costs 2.9 times more in Alaska than in Florida. 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· 51st of 51
$64.57
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.