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 $0.17 Median $0.27 Typical High $0.45 | Facility | None | $0.17 | $0.27 | $0.45 |
Aetna Setting Professional Modifier None Typical Low $0.17 Median $0.34 Typical High $0.45 | Professional | None | $0.17 | $0.34 | $0.45 |
Aetna Setting Professional Modifier 52 · Reduced service Typical Low $0.14 Median $0.22 Typical High $0.23 | Professional | 52 · Reduced service | $0.14 | $0.22 | $0.23 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $0.05 Median $0.09 Typical High $0.09 | Professional | 53 · Discontinued | $0.05 | $0.09 | $0.09 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $0.04 Median $0.06 Typical High $0.07 | Professional | 55 · Aftercare only | $0.04 | $0.06 | $0.07 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $0.03 Median $0.04 Typical High $0.05 | Professional | 56 · Pre-op care only | $0.03 | $0.04 | $0.05 |
Ambetter Setting Professional Modifier None Typical Low $25.70 Median $25.70 Typical High $43.65 | Professional | None | $25.70 | $25.70 | $43.65 |
AvMed Setting Facility Modifier None Typical Low $0.46 Median $0.46 Typical High $0.47 | Facility | None | $0.46 | $0.46 | $0.47 |
AvMed Setting Professional Modifier None Typical Low $0.45 Median $0.47 Typical High $0.58 | Professional | None | $0.45 | $0.47 | $0.58 |
Cigna Setting Facility Modifier None Typical Low $0.81 Median $0.81 Typical High $0.81 | Facility | None | $0.81 | $0.81 | $0.81 |
Cigna Setting Professional Modifier None Typical Low $0.31 Median $0.31 Typical High $0.31 | Professional | None | $0.31 | $0.31 | $0.31 |
Florida Blue Setting Facility Modifier None Typical Low $0.55 Median $0.55 Typical High $0.55 | Facility | None | $0.55 | $0.55 | $0.55 |
Florida Blue Setting Professional Modifier None Typical Low $0.18 Median $0.35 Typical High $0.46 | Professional | None | $0.18 | $0.35 | $0.46 |
Molina Setting Professional Modifier None Typical Low $3.09 Median $3.09 Typical High $3.09 | Professional | None | $3.09 | $3.09 | $3.09 |
United Setting Professional Modifier None Typical Low $0.26 Median $0.37 Typical High $60.26 | Professional | None | $0.26 | $0.37 | $60.26 |
Wellpoint Setting Professional Modifier None Typical Low $0.36 Median $0.36 Typical High $0.58 | Professional | None | $0.36 | $0.36 | $0.58 |
1 more rate 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 |
|---|---|---|---|---|---|
Aetna Setting Professional Modifier RR · Rental Typical Low $0.04 Median $0.17 Typical High $0.30 | Professional | RR · Rental | $0.04 | $0.17 | $0.30 |
Where Florida sits
The same service costs 4.6 times more in Hawaii than in Rhode Island. 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· 37th of 51
$0.31
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.