How much rates vary
Facilitymedian $78 · 10th to 90th $41 to $155Professionalmedian $59 · 10th to 90th $35 to $83
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 $58.88 Typical High $72.44 | Facility | None | $40.74 | $58.88 | $72.44 |
Aetna Setting Professional Modifier None Typical Low $40.74 Median $61.66 Typical High $77.62 | Professional | None | $40.74 | $61.66 | $77.62 |
Ambetter Setting Professional Modifier None Typical Low $35.48 Median $66.07 Typical High $81.28 | Professional | None | $35.48 | $66.07 | $81.28 |
AvMed Setting Facility Modifier None Typical Low $41.69 Median $61.66 Typical High $81.28 | Facility | None | $41.69 | $61.66 | $81.28 |
AvMed Setting Professional Modifier None Typical Low $41.69 Median $61.66 Typical High $81.28 | Professional | None | $41.69 | $61.66 | $81.28 |
Cigna Setting Facility Modifier None Typical Low $89.13 Median $120.23 Typical High $181.97 | Facility | None | $89.13 | $120.23 | $181.97 |
Cigna Setting Professional Modifier None Typical Low $33.88 Median $51.29 Typical High $79.43 | Professional | None | $33.88 | $51.29 | $79.43 |
Florida Blue Setting Facility Modifier None Typical Low $30.90 Median $30.90 Typical High $169.82 | Facility | None | $30.90 | $30.90 | $169.82 |
Florida Blue Setting Professional Modifier None Typical Low $33.11 Median $63.10 Typical High $141.25 | Professional | None | $33.11 | $63.10 | $141.25 |
Molina Setting Professional Modifier None Typical Low $38.90 Median $66.07 Typical High $141.25 | Professional | None | $38.90 | $66.07 | $141.25 |
United Setting Professional Modifier None Typical Low $35.48 Median $53.70 Typical High $79.43 | Professional | None | $35.48 | $53.70 | $79.43 |
Wellpoint Setting Professional Modifier None Typical Low $32.36 Median $58.88 Typical High $58.88 | Professional | None | $32.36 | $58.88 | $58.88 |
11 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 Facility Modifier 52 · Reduced service Typical Low $20.42 Median $25.12 Typical High $31.62 | Facility | 52 · Reduced service | $20.42 | $25.12 | $31.62 |
Aetna Setting Facility Modifier 55 · Aftercare only Typical Low $6.17 Median $7.59 Typical High $9.33 | Facility | 55 · Aftercare only | $6.17 | $7.59 | $9.33 |
Aetna Setting Facility Modifier 56 · Pre-op care only Typical Low $4.07 Median $5.01 Typical High $6.31 | Facility | 56 · Pre-op care only | $4.07 | $5.01 | $6.31 |
Aetna Setting Facility Modifier AF · Specialist physician Typical Low $58.88 Median $72.44 Typical High $81.28 | Facility | AF · Specialist physician | $58.88 | $72.44 | $81.28 |
Aetna Setting Facility Modifier HO · Master's level Typical Low $43.65 Median $54.95 Typical High $60.26 | Facility | HO · Master's level | $43.65 | $54.95 | $60.26 |
Aetna Setting Facility Modifier TD · Registered nurse Typical Low $50.12 Median $61.66 Typical High $67.61 | Facility | TD · Registered nurse | $50.12 | $61.66 | $67.61 |
Aetna Setting Professional Modifier 52 · Reduced service Typical Low $20.42 Median $27.54 Typical High $31.62 | Professional | 52 · Reduced service | $20.42 | $27.54 | $31.62 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $6.03 Median $8.32 Typical High $9.33 | Professional | 55 · Aftercare only | $6.03 | $8.32 | $9.33 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $4.07 Median $5.50 Typical High $6.31 | Professional | 56 · Pre-op care only | $4.07 | $5.50 | $6.31 |
Ambetter Setting Professional Modifier 25 · Same-day visit Typical Low $56.23 Median $66.07 Typical High $77.62 | Professional | 25 · Same-day visit | $56.23 | $66.07 | $77.62 |
Ambetter Setting Professional Modifier GC · Resident with teaching physician Typical Low $74.13 Median $74.13 Typical High $74.13 | Professional | GC · Resident with teaching physician | $74.13 | $74.13 | $74.13 |
Where Florida sits
The same service costs 2.2 times more in Alaska than in New Jersey. 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· 42nd of 51
$58.88
AK $107NJ $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.