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 $0.31 Median $3.47 Typical High $4.90 | Facility | None | $0.31 | $3.47 | $4.90 |
Aetna Setting Professional Modifier None Typical Low $0.24 Median $3.47 Typical High $4.90 | Professional | None | $0.24 | $3.47 | $4.90 |
Aetna Setting Professional Modifier 52 · Reduced service Typical Low $0.12 Median $1.74 Typical High $2.45 | Professional | 52 · Reduced service | $0.12 | $1.74 | $2.45 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $0.05 Median $0.71 Typical High $0.98 | Professional | 53 · Discontinued | $0.05 | $0.71 | $0.98 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $0.04 Median $0.52 Typical High $0.72 | Professional | 55 · Aftercare only | $0.04 | $0.52 | $0.72 |
Ambetter Setting Professional Modifier None Typical Low $9.33 Median $9.33 Typical High $9.33 | Professional | None | $9.33 | $9.33 | $9.33 |
Cigna Setting Facility Modifier None Typical Low $4.17 Median $5.62 Typical High $8.13 | Facility | None | $4.17 | $5.62 | $8.13 |
Cigna Setting Professional Modifier None Typical Low $3.72 Median $3.72 Typical High $3.72 | Professional | None | $3.72 | $3.72 | $3.72 |
Florida Blue Setting Professional Modifier None Typical Low $0.28 Median $0.36 Typical High $0.58 | Professional | None | $0.28 | $0.36 | $0.58 |
Molina Setting Professional Modifier None Typical Low $39.81 Median $39.81 Typical High $39.81 | Professional | None | $39.81 | $39.81 | $39.81 |
United Setting Professional Modifier None Typical Low $2.57 Median $2.82 Typical High $54.95 | Professional | None | $2.57 | $2.82 | $54.95 |
Wellpoint Setting Professional Modifier None Typical Low $4.17 Median $4.17 Typical High $4.37 | Professional | None | $4.17 | $4.17 | $4.37 |
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 |
|---|---|---|---|---|---|
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $0.27 Median $0.35 Typical High $0.49 | Professional | 56 · Pre-op care only | $0.27 | $0.35 | $0.49 |
Where Florida sits
The same service costs 4.6 times more in Ohio than in Hawaii. 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· 44th of 51
$3.72
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.