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 $100.00 Median $100.00 Typical High $125.89 | Facility | None | $100.00 | $100.00 | $125.89 |
Aetna Setting Professional Modifier None Typical Low $100.00 Median $109.65 Typical High $147.91 | Professional | None | $100.00 | $109.65 | $147.91 |
Aetna Setting Professional Modifier 52 · Reduced service Typical Low $50.12 Median $54.95 Typical High $66.07 | Professional | 52 · Reduced service | $50.12 | $54.95 | $66.07 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $19.95 Median $21.88 Typical High $26.92 | Professional | 53 · Discontinued | $19.95 | $21.88 | $26.92 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $14.79 Median $16.60 Typical High $19.95 | Professional | 55 · Aftercare only | $14.79 | $16.60 | $19.95 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $10.00 Median $10.96 Typical High $13.49 | Professional | 56 · Pre-op care only | $10.00 | $10.96 | $13.49 |
Ambetter Setting Professional Modifier None Typical Low $158.49 Median $181.97 Typical High $181.97 | Professional | None | $158.49 | $181.97 | $181.97 |
AvMed Setting Facility Modifier None Typical Low $245.47 Median $245.47 Typical High $245.47 | Facility | None | $245.47 | $245.47 | $245.47 |
AvMed Setting Professional Modifier None Typical Low $181.97 Median $229.09 Typical High $245.47 | Professional | None | $181.97 | $229.09 | $245.47 |
Cigna Setting Facility Modifier None Typical Low $151.36 Median $151.36 Typical High $154.88 | Facility | None | $151.36 | $151.36 | $154.88 |
Cigna Setting Professional Modifier None Typical Low $112.20 Median $112.20 Typical High $151.36 | Professional | None | $112.20 | $112.20 | $151.36 |
Florida Blue Setting Facility Modifier None Typical Low $457.09 Median $457.09 Typical High $457.09 | Facility | None | $457.09 | $457.09 | $457.09 |
Florida Blue Setting Professional Modifier None Typical Low $147.91 Median $245.47 Typical High $245.47 | Professional | None | $147.91 | $245.47 | $245.47 |
Molina Setting Professional Modifier None Typical Low $63.10 Median $83.18 Typical High $91.20 | Professional | None | $63.10 | $83.18 | $91.20 |
United Setting Facility Modifier None Typical Low $288.40 Median $288.40 Typical High $288.40 | Facility | None | $288.40 | $288.40 | $288.40 |
United Setting Professional Modifier None Typical Low $93.33 Median $117.49 Typical High $147.91 | Professional | None | $93.33 | $117.49 | $147.91 |
Wellpoint Setting Professional Modifier None Typical Low $83.18 Median $83.18 Typical High $245.47 | Professional | None | $83.18 | $83.18 | $245.47 |
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 $15.14 Median $15.14 Typical High $15.14 | Professional | RR · Rental | $15.14 | $15.14 | $15.14 |
Where Florida sits
The same service costs 2.1 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· 49th of 51
$112
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.