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 $158.49 Median $158.49 Typical High $158.49 | Facility | None | $158.49 | $158.49 | $158.49 |
Aetna Setting Professional Modifier None Typical Low $158.49 Median $158.49 Typical High $181.97 | Professional | None | $158.49 | $158.49 | $181.97 |
Aetna Setting Professional Modifier 52 · Reduced service Typical Low $79.43 Median $79.43 Typical High $91.20 | Professional | 52 · Reduced service | $79.43 | $79.43 | $91.20 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $31.62 Median $31.62 Typical High $36.31 | Professional | 53 · Discontinued | $31.62 | $31.62 | $36.31 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $23.44 Median $23.44 Typical High $26.92 | Professional | 55 · Aftercare only | $23.44 | $23.44 | $26.92 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $15.85 Median $15.85 Typical High $18.20 | Professional | 56 · Pre-op care only | $15.85 | $15.85 | $18.20 |
Ambetter Setting Professional Modifier None Typical Low $89.13 Median $100.00 Typical High $173.78 | Professional | None | $89.13 | $100.00 | $173.78 |
AvMed Setting Professional Modifier None Typical Low $102.33 Median $114.82 Typical High $165.96 | Professional | None | $102.33 | $114.82 | $165.96 |
Cigna Setting Facility Modifier None Typical Low $263.03 Median $645.65 Typical High $724.44 | Facility | None | $263.03 | $645.65 | $724.44 |
Cigna Setting Professional Modifier None Typical Low $165.96 Median $165.96 Typical High $165.96 | Professional | None | $165.96 | $165.96 | $165.96 |
Florida Blue Setting Facility Modifier None Typical Low $630.96 Median $630.96 Typical High $630.96 | Facility | None | $630.96 | $630.96 | $630.96 |
Florida Blue Setting Professional Modifier None Typical Low $72.44 Median $141.25 Typical High $169.82 | Professional | None | $72.44 | $141.25 | $169.82 |
Molina Setting Professional Modifier None Typical Low $50.12 Median $50.12 Typical High $295.12 | Professional | None | $50.12 | $50.12 | $295.12 |
United Setting Facility Modifier None Typical Low $380.19 Median $416.87 Typical High $416.87 | Facility | None | $380.19 | $416.87 | $416.87 |
United Setting Professional Modifier None Typical Low $112.20 Median $173.78 Typical High $316.23 | Professional | None | $112.20 | $173.78 | $316.23 |
Wellpoint Setting Professional Modifier None Typical Low $134.90 Median $134.90 Typical High $134.90 | Professional | None | $134.90 | $134.90 | $134.90 |
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 Q1 · Research study, routine Typical Low $186.21 Median $186.21 Typical High $186.21 | Professional | Q1 · Research study, routine | $186.21 | $186.21 | $186.21 |
Where Florida sits
The same service costs 3.2 times more in Alaska than in Connecticut. 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· 49th of 51
$166
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.