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 $0.38 Median $0.63 Typical High $0.66 | Facility | None | $0.38 | $0.63 | $0.66 |
Aetna Setting Professional Modifier None Typical Low $0.38 Median $0.63 Typical High $0.66 | Professional | None | $0.38 | $0.63 | $0.66 |
Aetna Setting Professional Modifier 52 · Reduced service Typical Low $0.19 Median $0.32 Typical High $0.33 | Professional | 52 · Reduced service | $0.19 | $0.32 | $0.33 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $0.08 Median $0.13 Typical High $0.13 | Professional | 53 · Discontinued | $0.08 | $0.13 | $0.13 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $0.06 Median $0.09 Typical High $0.10 | Professional | 55 · Aftercare only | $0.06 | $0.09 | $0.10 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $0.04 Median $0.06 Typical High $0.07 | Professional | 56 · Pre-op care only | $0.04 | $0.06 | $0.07 |
AvMed Setting Facility Modifier None Typical Low $0.72 Median $0.72 Typical High $0.72 | Facility | None | $0.72 | $0.72 | $0.72 |
AvMed Setting Professional Modifier None Typical Low $0.65 Median $0.78 Typical High $0.89 | Professional | None | $0.65 | $0.78 | $0.89 |
Cigna Setting Facility Modifier None Typical Low $1.23 Median $1.23 Typical High $1.23 | Facility | None | $1.23 | $1.23 | $1.23 |
Cigna Setting Professional Modifier None Typical Low $0.45 Median $0.45 Typical High $0.45 | Professional | None | $0.45 | $0.45 | $0.45 |
Florida Blue Setting Facility Modifier None Typical Low $0.85 Median $0.85 Typical High $0.85 | Facility | None | $0.85 | $0.85 | $0.85 |
Florida Blue Setting Professional Modifier None Typical Low $0.27 Median $0.54 Typical High $0.66 | Professional | None | $0.27 | $0.54 | $0.66 |
Molina Setting Professional Modifier None Typical Low $4.79 Median $4.79 Typical High $4.79 | Professional | None | $4.79 | $4.79 | $4.79 |
United Setting Professional Modifier None Typical Low $0.37 Median $0.52 Typical High $60.26 | Professional | None | $0.37 | $0.52 | $60.26 |
Wellpoint Setting Professional Modifier None Typical Low $0.38 Median $0.38 Typical High $0.89 | Professional | None | $0.38 | $0.38 | $0.89 |
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 Q6 · Substitute physician, paid per time Typical Low $44.67 Median $44.67 Typical High $44.67 | Professional | Q6 · Substitute physician, paid per time | $44.67 | $44.67 | $44.67 |
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· 41st of 51
$0.45
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.