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 $40.74 Median $40.74 Typical High $51.29 | Facility | None | $40.74 | $40.74 | $51.29 |
Aetna Setting Professional Modifier None Typical Low $40.74 Median $45.71 Typical High $54.95 | Professional | None | $40.74 | $45.71 | $54.95 |
Aetna Setting Professional Modifier 52 · Reduced service Typical Low $20.42 Median $22.39 Typical High $27.54 | Professional | 52 · Reduced service | $20.42 | $22.39 | $27.54 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $8.13 Median $9.12 Typical High $10.96 | Professional | 53 · Discontinued | $8.13 | $9.12 | $10.96 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $6.17 Median $6.76 Typical High $8.13 | Professional | 55 · Aftercare only | $6.17 | $6.76 | $8.13 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $4.07 Median $4.57 Typical High $5.50 | Professional | 56 · Pre-op care only | $4.07 | $4.57 | $5.50 |
AvMed Setting Facility Modifier None Typical Low $100.00 Median $100.00 Typical High $100.00 | Facility | None | $100.00 | $100.00 | $100.00 |
AvMed Setting Professional Modifier None Typical Low $74.13 Median $93.33 Typical High $100.00 | Professional | None | $74.13 | $93.33 | $100.00 |
Cigna Setting Facility Modifier None Typical Low $66.07 Median $66.07 Typical High $66.07 | Facility | None | $66.07 | $66.07 | $66.07 |
Cigna Setting Professional Modifier None Typical Low $48.98 Median $48.98 Typical High $66.07 | Professional | None | $48.98 | $48.98 | $66.07 |
Florida Blue Setting Facility Modifier None Typical Low $186.21 Median $186.21 Typical High $186.21 | Facility | None | $186.21 | $186.21 | $186.21 |
Florida Blue Setting Professional Modifier None Typical Low $52.48 Median $100.00 Typical High $100.00 | Professional | None | $52.48 | $100.00 | $100.00 |
Molina Setting Professional Modifier None Typical Low $28.18 Median $38.02 Typical High $41.69 | Professional | None | $28.18 | $38.02 | $41.69 |
United Setting Facility Modifier None Typical Low $120.23 Median $120.23 Typical High $120.23 | Facility | None | $120.23 | $120.23 | $120.23 |
United Setting Professional Modifier None Typical Low $38.90 Median $48.98 Typical High $60.26 | Professional | None | $38.90 | $48.98 | $60.26 |
Wellpoint Setting Professional Modifier None Typical Low $38.02 Median $38.02 Typical High $100.00 | Professional | None | $38.02 | $38.02 | $100.00 |
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 $6.61 Median $6.61 Typical High $6.61 | Professional | RR · Rental | $6.61 | $6.61 | $6.61 |
Where Florida sits
The same service costs 2.0 times more in Montana than in Vermont. 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· 48th of 51
$48.98
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.