How much rates vary
Distribution of negotiated rates across all payers (price axis is log-scale). 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 $3.47 Median $5.50 Typical High $5.75 | Facility | None | $3.47 | $5.50 | $5.75 |
Aetna Setting Professional Modifier None Typical Low $3.47 Median $5.50 Typical High $6.03 | Professional | None | $3.47 | $5.50 | $6.03 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $0.52 Median $0.83 Typical High $0.91 | Professional | 55 · Aftercare only | $0.52 | $0.83 | $0.91 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $0.34 Median $0.55 Typical High $0.62 | Professional | 56 · Pre-op care only | $0.34 | $0.55 | $0.62 |
AvMed Setting Professional Modifier None Typical Low $0.66 Median $6.17 Typical High $7.76 | Professional | None | $0.66 | $6.17 | $7.76 |
Cigna Setting Facility Modifier None Typical Low $5.37 Median $5.37 Typical High $5.37 | Facility | None | $5.37 | $5.37 | $5.37 |
Cigna Setting Professional Modifier None Typical Low $4.57 Median $4.57 Typical High $5.37 | Professional | None | $4.57 | $4.57 | $5.37 |
Florida Blue Setting Facility Modifier None Typical Low $10.96 Median $22.39 Typical High $34.67 | Facility | None | $10.96 | $22.39 | $34.67 |
Florida Blue Setting Professional Modifier None Typical Low $4.68 Median $7.76 Typical High $7.76 | Professional | None | $4.68 | $7.76 | $7.76 |
Molina Setting Professional Modifier None Typical Low $1.48 Median $1.95 Typical High $2.19 | Professional | None | $1.48 | $1.95 | $2.19 |
United Setting Professional Modifier None Typical Low $2.95 Median $3.80 Typical High $34.67 | Professional | None | $2.95 | $3.80 | $34.67 |
Wellpoint Setting Professional Modifier None Typical Low $1.95 Median $1.95 Typical High $7.76 | Professional | None | $1.95 | $1.95 | $7.76 |
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 |
|---|---|---|---|---|---|
Ambetter Setting Professional Modifier KX · Policy requirements met Typical Low $4.07 Median $10.00 Typical High $10.00 | Professional | KX · Policy requirements met | $4.07 | $10.00 | $10.00 |
Where Florida sits
The same service costs 4.2 times more in Hawaii than in Kentucky. 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
$4.57
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.