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 $27.54 Median $34.67 Typical High $58.88 | Facility | None | $27.54 | $34.67 | $58.88 |
Aetna Setting Professional Modifier None Typical Low $27.54 Median $31.62 Typical High $54.95 | Professional | None | $27.54 | $31.62 | $54.95 |
Ambetter Setting Professional Modifier None Typical Low $42.66 Median $50.12 Typical High $54.95 | Professional | None | $42.66 | $50.12 | $54.95 |
AvMed Setting Facility Modifier None Typical Low $67.61 Median $67.61 Typical High $67.61 | Facility | None | $67.61 | $67.61 | $67.61 |
AvMed Setting Professional Modifier None Typical Low $50.12 Median $63.10 Typical High $67.61 | Professional | None | $50.12 | $63.10 | $67.61 |
Cigna Setting Facility Modifier None Typical Low $45.71 Median $45.71 Typical High $45.71 | Facility | None | $45.71 | $45.71 | $45.71 |
Cigna Setting Professional Modifier None Typical Low $33.11 Median $33.11 Typical High $45.71 | Professional | None | $33.11 | $33.11 | $45.71 |
Florida Blue Setting Facility Modifier None Typical Low $50.12 Median $125.89 Typical High $125.89 | Facility | None | $50.12 | $125.89 | $125.89 |
Florida Blue Setting Professional Modifier None Typical Low $40.74 Median $67.61 Typical High $67.61 | Professional | None | $40.74 | $67.61 | $67.61 |
Molina Setting Professional Modifier None Typical Low $14.13 Median $18.62 Typical High $20.42 | Professional | None | $14.13 | $18.62 | $20.42 |
United Setting Facility Modifier None Typical Low $43.65 Median $52.48 Typical High $89.13 | Facility | None | $43.65 | $52.48 | $89.13 |
United Setting Professional Modifier None Typical Low $26.30 Median $33.11 Typical High $44.67 | Professional | None | $26.30 | $33.11 | $44.67 |
Wellpoint Setting Professional Modifier None Typical Low $18.62 Median $18.62 Typical High $67.61 | Professional | None | $18.62 | $18.62 | $67.61 |
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 $13.80 Median $15.14 Typical High $19.95 | Professional | 52 · Reduced service | $13.80 | $15.14 | $19.95 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $5.50 Median $6.03 Typical High $8.13 | Professional | 53 · Discontinued | $5.50 | $6.03 | $8.13 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $4.07 Median $4.57 Typical High $6.03 | Professional | 55 · Aftercare only | $4.07 | $4.57 | $6.03 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $2.75 Median $3.02 Typical High $3.98 | Professional | 56 · Pre-op care only | $2.75 | $3.02 | $3.98 |
Cigna Setting Professional Modifier RR · Rental Typical Low $4.57 Median $4.57 Typical High $4.57 | Professional | RR · Rental | $4.57 | $4.57 | $4.57 |
Where Florida sits
The same service costs 3.8 times more in Hawaii than in Florida. 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· 51st of 51
$33.11
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.