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 $1.10 Median $1.78 Typical High $1.86 | Facility | None | $1.10 | $1.78 | $1.86 |
Aetna Setting Professional Modifier None Typical Low $1.10 Median $1.78 Typical High $1.86 | Professional | None | $1.10 | $1.78 | $1.86 |
Aetna Setting Professional Modifier 52 · Reduced service Typical Low $0.55 Median $0.89 Typical High $0.93 | Professional | 52 · Reduced service | $0.55 | $0.89 | $0.93 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $0.22 Median $0.35 Typical High $0.37 | Professional | 53 · Discontinued | $0.22 | $0.35 | $0.37 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $0.17 Median $0.27 Typical High $0.28 | Professional | 55 · Aftercare only | $0.17 | $0.27 | $0.28 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $0.11 Median $0.18 Typical High $0.19 | Professional | 56 · Pre-op care only | $0.11 | $0.18 | $0.19 |
Ambetter Setting Professional Modifier None Typical Low $1.12 Median $1.74 Typical High $2.19 | Professional | None | $1.12 | $1.74 | $2.19 |
AvMed Setting Facility Modifier None Typical Low $2.00 Median $2.00 Typical High $2.00 | Facility | None | $2.00 | $2.00 | $2.00 |
AvMed Setting Professional Modifier None Typical Low $1.82 Median $2.14 Typical High $2.51 | Professional | None | $1.82 | $2.14 | $2.51 |
Cigna Setting Facility Modifier None Typical Low $3.39 Median $3.39 Typical High $3.39 | Facility | None | $3.39 | $3.39 | $3.39 |
Cigna Setting Professional Modifier None Typical Low $1.26 Median $1.26 Typical High $1.26 | Professional | None | $1.26 | $1.26 | $1.26 |
Florida Blue Setting Facility Modifier None Typical Low $2.40 Median $2.40 Typical High $2.40 | Facility | None | $2.40 | $2.40 | $2.40 |
Florida Blue Setting Professional Modifier None Typical Low $0.76 Median $1.51 Typical High $1.86 | Professional | None | $0.76 | $1.51 | $1.86 |
Molina Setting Professional Modifier None Typical Low $13.49 Median $13.49 Typical High $13.49 | Professional | None | $13.49 | $13.49 | $13.49 |
United Setting Professional Modifier None Typical Low $1.05 Median $1.48 Typical High $60.26 | Professional | None | $1.05 | $1.48 | $60.26 |
Wellpoint Setting Professional Modifier None Typical Low $0.54 Median $0.54 Typical High $2.51 | Professional | None | $0.54 | $0.54 | $2.51 |
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 A1 · Dressing, 1 wound Typical Low $1.74 Median $1.74 Typical High $1.74 | Professional | A1 · Dressing, 1 wound | $1.74 | $1.74 | $1.74 |
Where Florida sits
The same service costs 2.6 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· 39th of 51
$1.26
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.