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 $19.50 Median $31.62 Typical High $33.11 | Facility | None | $19.50 | $31.62 | $33.11 |
Aetna Setting Professional Modifier None Typical Low $19.50 Median $31.62 Typical High $33.11 | Professional | None | $19.50 | $31.62 | $33.11 |
Aetna Setting Professional Modifier 52 · Reduced service Typical Low $9.77 Median $15.85 Typical High $16.22 | Professional | 52 · Reduced service | $9.77 | $15.85 | $16.22 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $3.89 Median $6.31 Typical High $6.61 | Professional | 53 · Discontinued | $3.89 | $6.31 | $6.61 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $2.95 Median $4.68 Typical High $4.90 | Professional | 55 · Aftercare only | $2.95 | $4.68 | $4.90 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $1.95 Median $3.16 Typical High $3.31 | Professional | 56 · Pre-op care only | $1.95 | $3.16 | $3.31 |
Ambetter Setting Professional Modifier None Typical Low $30.90 Median $30.90 Typical High $30.90 | Professional | None | $30.90 | $30.90 | $30.90 |
AvMed Setting Facility Modifier None Typical Low $15.85 Median $15.85 Typical High $35.48 | Facility | None | $15.85 | $15.85 | $35.48 |
AvMed Setting Professional Modifier None Typical Low $15.85 Median $35.48 Typical High $43.65 | Professional | None | $15.85 | $35.48 | $43.65 |
Cigna Setting Facility Modifier None Typical Low $60.26 Median $60.26 Typical High $60.26 | Facility | None | $60.26 | $60.26 | $60.26 |
Cigna Setting Professional Modifier None Typical Low $21.88 Median $21.88 Typical High $21.88 | Professional | None | $21.88 | $21.88 | $21.88 |
Florida Blue Setting Facility Modifier None Typical Low $41.69 Median $41.69 Typical High $41.69 | Facility | None | $41.69 | $41.69 | $41.69 |
Florida Blue Setting Professional Modifier None Typical Low $13.18 Median $26.30 Typical High $33.11 | Professional | None | $13.18 | $26.30 | $33.11 |
Molina Setting Professional Modifier None Typical Low $234.42 Median $234.42 Typical High $234.42 | Professional | None | $234.42 | $234.42 | $234.42 |
United Setting Professional Modifier None Typical Low $15.14 Median $15.85 Typical High $60.26 | Professional | None | $15.14 | $15.85 | $60.26 |
Wellpoint Setting Professional Modifier None Typical Low $19.05 Median $19.05 Typical High $43.65 | Professional | None | $19.05 | $19.05 | $43.65 |
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 A1 · Dressing, 1 wound Typical Low $30.90 Median $30.90 Typical High $30.90 | Professional | A1 · Dressing, 1 wound | $30.90 | $30.90 | $30.90 |
Ambetter Setting Professional Modifier A4 · Dressing, 4 wounds Typical Low $30.90 Median $30.90 Typical High $30.90 | Professional | A4 · Dressing, 4 wounds | $30.90 | $30.90 | $30.90 |
Where Florida sits
The same service costs 3.2 times more in Hawaii than in Utah. 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· 38th of 51
$21.88
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.