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 $64.57 Median $64.57 Typical High $81.28 | Facility | None | $64.57 | $64.57 | $81.28 |
Aetna Setting Professional Modifier None Typical Low $64.57 Median $70.79 Typical High $91.20 | Professional | None | $64.57 | $70.79 | $91.20 |
Aetna Setting Professional Modifier 52 · Reduced service Typical Low $32.36 Median $35.48 Typical High $40.74 | Professional | 52 · Reduced service | $32.36 | $35.48 | $40.74 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $12.88 Median $14.13 Typical High $16.22 | Professional | 53 · Discontinued | $12.88 | $14.13 | $16.22 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $9.55 Median $10.72 Typical High $12.30 | Professional | 55 · Aftercare only | $9.55 | $10.72 | $12.30 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $6.46 Median $7.08 Typical High $8.13 | Professional | 56 · Pre-op care only | $6.46 | $7.08 | $8.13 |
Ambetter Setting Professional Modifier None Typical Low $100.00 Median $117.49 Typical High $117.49 | Professional | None | $100.00 | $117.49 | $117.49 |
AvMed Setting Facility Modifier None Typical Low $158.49 Median $158.49 Typical High $158.49 | Facility | None | $158.49 | $158.49 | $158.49 |
AvMed Setting Professional Modifier None Typical Low $117.49 Median $147.91 Typical High $158.49 | Professional | None | $117.49 | $147.91 | $158.49 |
Cigna Setting Facility Modifier None Typical Low $81.28 Median $87.10 Typical High $87.10 | Facility | None | $81.28 | $87.10 | $87.10 |
Cigna Setting Professional Modifier None Typical Low $63.10 Median $63.10 Typical High $87.10 | Professional | None | $63.10 | $63.10 | $87.10 |
Florida Blue Setting Facility Modifier None Typical Low $75.86 Median $295.12 Typical High $295.12 | Facility | None | $75.86 | $295.12 | $295.12 |
Florida Blue Setting Professional Modifier None Typical Low $95.50 Median $158.49 Typical High $158.49 | Professional | None | $95.50 | $158.49 | $158.49 |
Molina Setting Professional Modifier None Typical Low $67.61 Median $89.13 Typical High $100.00 | Professional | None | $67.61 | $89.13 | $100.00 |
United Setting Facility Modifier None Typical Low $91.20 Median $120.23 Typical High $186.21 | Facility | None | $91.20 | $120.23 | $186.21 |
United Setting Professional Modifier None Typical Low $60.26 Median $75.86 Typical High $93.33 | Professional | None | $60.26 | $75.86 | $93.33 |
Wellpoint Setting Professional Modifier None Typical Low $89.13 Median $89.13 Typical High $158.49 | Professional | None | $89.13 | $89.13 | $158.49 |
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 |
|---|---|---|---|---|---|
Cigna Setting Professional Modifier RR · Rental Typical Low $8.71 Median $8.71 Typical High $8.71 | Professional | RR · Rental | $8.71 | $8.71 | $8.71 |
Where Florida sits
The same service costs 5.0 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· 41st of 51
$77.62
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.