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 $85.11 Median $85.11 Typical High $112.20 | Facility | None | $85.11 | $85.11 | $112.20 |
Aetna Setting Professional Modifier None Typical Low $85.11 Median $93.33 Typical High $128.82 | Professional | None | $85.11 | $93.33 | $128.82 |
Ambetter Setting Professional Modifier None Typical Low $154.88 Median $154.88 Typical High $194.98 | Professional | None | $154.88 | $154.88 | $194.98 |
AvMed Setting Facility Modifier None Typical Low $208.93 Median $208.93 Typical High $208.93 | Facility | None | $208.93 | $208.93 | $208.93 |
AvMed Setting Professional Modifier None Typical Low $165.96 Median $208.93 Typical High $208.93 | Professional | None | $165.96 | $208.93 | $208.93 |
Cigna Setting Facility Modifier None Typical Low $107.15 Median $125.89 Typical High $125.89 | Facility | None | $107.15 | $125.89 | $125.89 |
Cigna Setting Facility Modifier RR · Rental Typical Low $12.59 Median $12.59 Typical High $12.59 | Facility | RR · Rental | $12.59 | $12.59 | $12.59 |
Cigna Setting Professional Modifier None Typical Low $93.33 Median $93.33 Typical High $125.89 | Professional | None | $93.33 | $93.33 | $125.89 |
Cigna Setting Professional Modifier RR · Rental Typical Low $10.72 Median $10.72 Typical High $12.59 | Professional | RR · Rental | $10.72 | $10.72 | $12.59 |
Florida Blue Setting Facility Modifier None Typical Low $380.19 Median $380.19 Typical High $380.19 | Facility | None | $380.19 | $380.19 | $380.19 |
Florida Blue Setting Professional Modifier None Typical Low $123.03 Median $208.93 Typical High $208.93 | Professional | None | $123.03 | $208.93 | $208.93 |
Molina Setting Professional Modifier None Typical Low $79.43 Median $107.15 Typical High $107.15 | Professional | None | $79.43 | $107.15 | $107.15 |
United Setting Facility Modifier None Typical Low $245.47 Median $245.47 Typical High $245.47 | Facility | None | $245.47 | $245.47 | $245.47 |
United Setting Professional Modifier None Typical Low $79.43 Median $102.33 Typical High $131.83 | Professional | None | $79.43 | $102.33 | $131.83 |
Wellpoint Setting Professional Modifier None Typical Low $107.15 Median $107.15 Typical High $208.93 | Professional | None | $107.15 | $107.15 | $208.93 |
4 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 $41.69 Median $46.77 Typical High $56.23 | Professional | 52 · Reduced service | $41.69 | $46.77 | $56.23 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $16.98 Median $18.62 Typical High $22.39 | Professional | 53 · Discontinued | $16.98 | $18.62 | $22.39 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $12.59 Median $14.13 Typical High $16.98 | Professional | 55 · Aftercare only | $12.59 | $14.13 | $16.98 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $8.51 Median $9.33 Typical High $11.22 | Professional | 56 · Pre-op care only | $8.51 | $9.33 | $11.22 |
Where Florida sits
The same service costs 2.1 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· 46th of 51
$107
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.