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 $204.17 Median $204.17 Typical High $275.42 | Facility | None | $204.17 | $204.17 | $275.42 |
Aetna Setting Professional Modifier None Typical Low $181.97 Median $218.78 Typical High $275.42 | Professional | None | $181.97 | $218.78 | $275.42 |
Ambetter Setting Professional Modifier None Typical Low $309.03 Median $309.03 Typical High $309.03 | Professional | None | $309.03 | $309.03 | $309.03 |
AvMed Setting Facility Modifier None Typical Low $316.23 Median $316.23 Typical High $316.23 | Facility | None | $316.23 | $316.23 | $316.23 |
AvMed Setting Professional Modifier None Typical Low $257.04 Median $316.23 Typical High $338.84 | Professional | None | $257.04 | $316.23 | $338.84 |
Cigna Setting Facility Modifier None Typical Low $302.00 Median $302.00 Typical High $302.00 | Facility | None | $302.00 | $302.00 | $302.00 |
Cigna Setting Facility Modifier RR · Rental Typical Low $30.20 Median $30.20 Typical High $30.20 | Facility | RR · Rental | $30.20 | $30.20 | $30.20 |
Cigna Setting Professional Modifier None Typical Low $218.78 Median $218.78 Typical High $302.00 | Professional | None | $218.78 | $218.78 | $302.00 |
Cigna Setting Professional Modifier RR · Rental Typical Low $25.70 Median $25.70 Typical High $30.20 | Professional | RR · Rental | $25.70 | $25.70 | $30.20 |
Florida Blue Setting Facility Modifier None Typical Low $588.84 Median $588.84 Typical High $758.58 | Facility | None | $588.84 | $588.84 | $758.58 |
Florida Blue Setting Professional Modifier None Typical Low $190.55 Median $316.23 Typical High $389.05 | Professional | None | $190.55 | $316.23 | $389.05 |
Molina Setting Professional Modifier None Typical Low $213.80 Median $281.84 Typical High $281.84 | Professional | None | $213.80 | $281.84 | $281.84 |
United Setting Facility Modifier None Typical Low $489.78 Median $489.78 Typical High $489.78 | Facility | None | $489.78 | $489.78 | $489.78 |
United Setting Professional Modifier None Typical Low $169.82 Median $251.19 Typical High $309.03 | Professional | None | $169.82 | $251.19 | $309.03 |
Wellpoint Setting Professional Modifier None Typical Low $281.84 Median $281.84 Typical High $316.23 | Professional | None | $281.84 | $281.84 | $316.23 |
5 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 $89.13 Median $107.15 Typical High $134.90 | Professional | 52 · Reduced service | $89.13 | $107.15 | $134.90 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $35.48 Median $42.66 Typical High $54.95 | Professional | 53 · Discontinued | $35.48 | $42.66 | $54.95 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $26.92 Median $31.62 Typical High $40.74 | Professional | 55 · Aftercare only | $26.92 | $31.62 | $40.74 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $17.78 Median $21.38 Typical High $27.54 | Professional | 56 · Pre-op care only | $17.78 | $21.38 | $27.54 |
Ambetter Setting Professional Modifier KX · Policy requirements met Typical Low $309.03 Median $309.03 Typical High $309.03 | Professional | KX · Policy requirements met | $309.03 | $309.03 | $309.03 |
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· 31st of 51
$251
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.