How much rates vary
Facilitymedian $91 · 10th to 90th $66 to $155Professionalmedian $105 · 10th to 90th $72 to $191
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 $66.07 Median $75.86 Typical High $104.71 | Facility | None | $66.07 | $75.86 | $104.71 |
Aetna Setting Professional Modifier None Typical Low $66.07 Median $89.13 Typical High $173.78 | Professional | None | $66.07 | $89.13 | $173.78 |
Ambetter Setting Professional Modifier None Typical Low $77.62 Median $123.03 Typical High $204.17 | Professional | None | $77.62 | $123.03 | $204.17 |
Anthem BCBS Setting Professional Modifier None Typical Low $75.86 Median $104.71 Typical High $165.96 | Professional | None | $75.86 | $104.71 | $165.96 |
CareSource Setting Professional Modifier None Typical Low $102.33 Median $131.83 Typical High $162.18 | Professional | None | $102.33 | $131.83 | $162.18 |
Cigna Setting Facility Modifier None Typical Low $125.89 Median $144.54 Typical High $218.78 | Facility | None | $125.89 | $144.54 | $218.78 |
Cigna Setting Professional Modifier None Typical Low $77.62 Median $109.65 Typical High $245.47 | Professional | None | $77.62 | $109.65 | $245.47 |
Kaiser Permanente Setting Professional Modifier None Typical Low $72.44 Median $120.23 Typical High $186.21 | Professional | None | $72.44 | $120.23 | $186.21 |
Oscar Health Setting Professional Modifier None Typical Low $85.11 Median $134.90 Typical High $234.42 | Professional | None | $85.11 | $134.90 | $234.42 |
United Setting Professional Modifier None Typical Low $74.13 Median $112.20 Typical High $223.87 | Professional | None | $74.13 | $112.20 | $223.87 |
16 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 $33.11 Median $44.67 Typical High $50.12 | Facility | 52 · Reduced service | $33.11 | $44.67 | $50.12 |
Aetna Setting Facility Modifier 55 · Aftercare only Typical Low $9.77 Median $13.18 Typical High $15.14 | Facility | 55 · Aftercare only | $9.77 | $13.18 | $15.14 |
Aetna Setting Facility Modifier 56 · Pre-op care only Typical Low $6.61 Median $8.91 Typical High $10.23 | Facility | 56 · Pre-op care only | $6.61 | $8.91 | $10.23 |
Aetna Setting Professional Modifier 52 · Reduced service Typical Low $33.11 Median $42.66 Typical High $46.77 | Professional | 52 · Reduced service | $33.11 | $42.66 | $46.77 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $9.77 Median $12.88 Typical High $14.13 | Professional | 55 · Aftercare only | $9.77 | $12.88 | $14.13 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $6.61 Median $8.51 Typical High $9.33 | Professional | 56 · Pre-op care only | $6.61 | $8.51 | $9.33 |
Ambetter Setting Professional Modifier 24 · Unrelated visit after surgery Typical Low $213.80 Median $213.80 Typical High $213.80 | Professional | 24 · Unrelated visit after surgery | $213.80 | $213.80 | $213.80 |
Ambetter Setting Professional Modifier 25 · Same-day visit Typical Low $93.33 Median $123.03 Typical High $204.17 | Professional | 25 · Same-day visit | $93.33 | $123.03 | $204.17 |
Ambetter Setting Professional Modifier 57 · Decision for surgery Typical Low $169.82 Median $213.80 Typical High $229.09 | Professional | 57 · Decision for surgery | $169.82 | $213.80 | $229.09 |
Ambetter Setting Professional Modifier 93 · Audio-only telehealth Typical Low $125.89 Median $125.89 Typical High $125.89 | Professional | 93 · Audio-only telehealth | $125.89 | $125.89 | $125.89 |
Ambetter Setting Professional Modifier GC · Resident with teaching physician Typical Low $123.03 Median $134.90 Typical High $190.55 | Professional | GC · Resident with teaching physician | $123.03 | $134.90 | $190.55 |
Ambetter Setting Professional Modifier GY · Excluded by law Typical Low $109.65 Median $109.65 Typical High $109.65 | Professional | GY · Excluded by law | $109.65 | $109.65 | $109.65 |
Ambetter Setting Professional Modifier Q6 · Substitute physician, paid per time Typical Low $162.18 Median $190.55 Typical High $190.55 | Professional | Q6 · Substitute physician, paid per time | $162.18 | $190.55 | $190.55 |
Ambetter Setting Professional Modifier SA · Nurse practitioner Typical Low $114.82 Median $162.18 Typical High $162.18 | Professional | SA · Nurse practitioner | $114.82 | $162.18 | $162.18 |
Anthem BCBS Setting Professional Modifier 25 · Same-day visit Typical Low $89.13 Median $89.13 Typical High $89.13 | Professional | 25 · Same-day visit | $89.13 | $89.13 | $89.13 |
Anthem BCBS Setting Professional Modifier EP · Child screening program Typical Low $75.86 Median $109.65 Typical High $109.65 | Professional | EP · Child screening program | $75.86 | $109.65 | $109.65 |
Where Georgia sits
The same service costs 2.3 times more in Alaska than in Alabama. 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.
Georgia· 21st of 51
$105
AK $170AL $74.13
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.