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 $1.29 Median $2.09 Typical High $2.19 | Facility | None | $1.29 | $2.09 | $2.19 |
Aetna Setting Professional Modifier None Typical Low $1.29 Median $2.00 Typical High $2.19 | Professional | None | $1.29 | $2.00 | $2.19 |
Aetna Setting Professional Modifier 52 · Reduced service Typical Low $0.65 Median $1.05 Typical High $1.10 | Professional | 52 · Reduced service | $0.65 | $1.05 | $1.10 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $0.26 Median $0.42 Typical High $0.44 | Professional | 53 · Discontinued | $0.26 | $0.42 | $0.44 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $0.20 Median $0.32 Typical High $0.33 | Professional | 55 · Aftercare only | $0.20 | $0.32 | $0.33 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $0.13 Median $0.21 Typical High $0.22 | Professional | 56 · Pre-op care only | $0.13 | $0.21 | $0.22 |
Ambetter Setting Professional Modifier None Typical Low $1.35 Median $1.48 Typical High $1.78 | Professional | None | $1.35 | $1.48 | $1.78 |
AvMed Setting Professional Modifier None Typical Low $2.19 Median $2.63 Typical High $2.95 | Professional | None | $2.19 | $2.63 | $2.95 |
Cigna Setting Facility Modifier None Typical Low $1.74 Median $1.74 Typical High $2.14 | Facility | None | $1.74 | $1.74 | $2.14 |
Cigna Setting Professional Modifier None Typical Low $1.48 Median $1.48 Typical High $1.74 | Professional | None | $1.48 | $1.48 | $1.74 |
Florida Blue Setting Facility Modifier None Typical Low $2.82 Median $2.82 Typical High $2.82 | Facility | None | $2.82 | $2.82 | $2.82 |
Florida Blue Setting Professional Modifier None Typical Low $1.78 Median $2.95 Typical High $2.95 | Professional | None | $1.78 | $2.95 | $2.95 |
Molina Setting Professional Modifier None Typical Low $1.02 Median $1.26 Typical High $1.41 | Professional | None | $1.02 | $1.26 | $1.41 |
United Setting Professional Modifier None Typical Low $1.10 Median $1.45 Typical High $34.67 | Professional | None | $1.10 | $1.45 | $34.67 |
Wellpoint Setting Professional Modifier None Typical Low $1.26 Median $1.26 Typical High $2.95 | Professional | None | $1.26 | $1.26 | $2.95 |
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 $2.04 Median $2.04 Typical High $2.04 | Professional | KX · Policy requirements met | $2.04 | $2.04 | $2.04 |
Where Florida sits
The same service costs 2.2 times more in Kansas than in Alabama. 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· 50th of 51
$1.48
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.