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 $38.02 Median $38.02 Typical High $48.98 | Facility | None | $38.02 | $38.02 | $48.98 |
Aetna Setting Professional Modifier None Typical Low $38.02 Median $45.71 Typical High $72.44 | Professional | None | $38.02 | $45.71 | $72.44 |
Ambetter Setting Professional Modifier None Typical Low $60.26 Median $70.79 Typical High $89.13 | Professional | None | $60.26 | $70.79 | $89.13 |
AvMed Setting Facility Modifier None Typical Low $93.33 Median $93.33 Typical High $93.33 | Facility | None | $93.33 | $93.33 | $93.33 |
AvMed Setting Professional Modifier None Typical Low $69.18 Median $87.10 Typical High $93.33 | Professional | None | $69.18 | $87.10 | $93.33 |
Cigna Setting Facility Modifier None Typical Low $57.54 Median $57.54 Typical High $57.54 | Facility | None | $57.54 | $57.54 | $57.54 |
Cigna Setting Professional Modifier None Typical Low $42.66 Median $42.66 Typical High $57.54 | Professional | None | $42.66 | $42.66 | $57.54 |
Florida Blue Setting Facility Modifier None Typical Low $173.78 Median $173.78 Typical High $173.78 | Facility | None | $173.78 | $173.78 | $173.78 |
Florida Blue Setting Professional Modifier None Typical Low $56.23 Median $93.33 Typical High $93.33 | Professional | None | $56.23 | $93.33 | $93.33 |
Molina Setting Professional Modifier None Typical Low $31.62 Median $41.69 Typical High $46.77 | Professional | None | $31.62 | $41.69 | $46.77 |
United Setting Facility Modifier None Typical Low $43.65 Median $51.29 Typical High $123.03 | Facility | None | $43.65 | $51.29 | $123.03 |
United Setting Professional Modifier None Typical Low $37.15 Median $45.71 Typical High $60.26 | Professional | None | $37.15 | $45.71 | $60.26 |
Wellpoint Setting Professional Modifier None Typical Low $41.69 Median $41.69 Typical High $93.33 | Professional | None | $41.69 | $41.69 | $93.33 |
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 $19.05 Median $21.38 Typical High $26.92 | Professional | 52 · Reduced service | $19.05 | $21.38 | $26.92 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $7.59 Median $8.51 Typical High $10.72 | Professional | 53 · Discontinued | $7.59 | $8.51 | $10.72 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $5.75 Median $6.31 Typical High $8.13 | Professional | 55 · Aftercare only | $5.75 | $6.31 | $8.13 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $3.80 Median $4.27 Typical High $5.37 | Professional | 56 · Pre-op care only | $3.80 | $4.27 | $5.37 |
Cigna Setting Professional Modifier RR · Rental Typical Low $5.75 Median $5.75 Typical High $5.75 | Professional | RR · Rental | $5.75 | $5.75 | $5.75 |
Where Florida sits
The same service costs 2.6 times more in Hawaii than in Delaware. 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
$45.71
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.