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 $316.23 Median $407.38 Typical High $436.52 | Facility | None | $316.23 | $407.38 | $436.52 |
Aetna Setting Professional Modifier None Typical Low $302.00 Median $380.19 Typical High $436.52 | Professional | None | $302.00 | $380.19 | $436.52 |
Ambetter Setting Professional Modifier None Typical Low $389.05 Median $549.54 Typical High $645.65 | Professional | None | $389.05 | $549.54 | $645.65 |
AvMed Setting Facility Modifier None Typical Low $371.54 Median $407.38 Typical High $524.81 | Facility | None | $371.54 | $407.38 | $524.81 |
AvMed Setting Professional Modifier None Typical Low $309.03 Median $398.11 Typical High $512.86 | Professional | None | $309.03 | $398.11 | $512.86 |
Cigna Setting Facility Modifier None Typical Low $512.86 Median $512.86 Typical High $512.86 | Facility | None | $512.86 | $512.86 | $512.86 |
Cigna Setting Professional Modifier None Typical Low $457.09 Median $457.09 Typical High $457.09 | Professional | None | $457.09 | $457.09 | $457.09 |
Florida Blue Setting Facility Modifier None Typical Low $338.84 Median $338.84 Typical High $346.74 | Facility | None | $338.84 | $338.84 | $346.74 |
Florida Blue Setting Professional Modifier None Typical Low $177.83 Median $398.11 Typical High $537.03 | Professional | None | $177.83 | $398.11 | $537.03 |
Molina Setting Professional Modifier None Typical Low $446.68 Median $616.60 Typical High $1,202.26 | Professional | None | $446.68 | $616.60 | $1,202.26 |
United Setting Facility Modifier None Typical Low $204.17 Median $223.87 Typical High $223.87 | Facility | None | $204.17 | $223.87 | $223.87 |
United Setting Professional Modifier None Typical Low $218.78 Median $309.03 Typical High $489.78 | Professional | None | $218.78 | $309.03 | $489.78 |
Wellpoint Setting Professional Modifier None Typical Low $363.08 Median $489.78 Typical High $489.78 | Professional | None | $363.08 | $489.78 | $489.78 |
4 more rates 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 52 · Reduced service Typical Low $199.53 Median $208.93 Typical High $213.80 | Professional | 52 · Reduced service | $199.53 | $208.93 | $213.80 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $79.43 Median $83.18 Typical High $87.10 | Professional | 53 · Discontinued | $79.43 | $83.18 | $87.10 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $60.26 Median $63.10 Typical High $64.57 | Professional | 55 · Aftercare only | $60.26 | $63.10 | $64.57 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $39.81 Median $41.69 Typical High $43.65 | Professional | 56 · Pre-op care only | $39.81 | $41.69 | $43.65 |
Where Florida sits
The same service costs 2.1 times more in Wyoming than in Maryland. 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· 28th of 51
$407
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.