How much rates vary
Facilitymedian $135 · 10th to 90th $107 to $162Professionalmedian $162 · 10th to 90th $117 to $288
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 $107.15 Median $131.83 Typical High $158.49 | Facility | None | $107.15 | $131.83 | $158.49 |
Aetna Setting Professional Modifier None Typical Low $104.71 Median $138.04 Typical High $281.84 | Professional | None | $104.71 | $138.04 | $281.84 |
Ambetter Setting Professional Modifier None Typical Low $120.23 Median $186.21 Typical High $309.03 | Professional | None | $120.23 | $186.21 | $309.03 |
Anthem BCBS Setting Professional Modifier None Typical Low $123.03 Median $162.18 Typical High $275.42 | Professional | None | $123.03 | $162.18 | $275.42 |
CareSource Setting Professional Modifier None Typical Low $151.36 Median $199.53 Typical High $245.47 | Professional | None | $151.36 | $199.53 | $245.47 |
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 $128.82 Median $165.96 Typical High $371.54 | Professional | None | $128.82 | $165.96 | $371.54 |
Kaiser Permanente Setting Professional Modifier None Typical Low $120.23 Median $181.97 Typical High $263.03 | Professional | None | $120.23 | $181.97 | $263.03 |
Oscar Health Setting Professional Modifier None Typical Low $138.04 Median $218.78 Typical High $363.08 | Professional | None | $138.04 | $218.78 | $363.08 |
United Setting Professional Modifier None Typical Low $125.89 Median $169.82 Typical High $331.13 | Professional | None | $125.89 | $169.82 | $331.13 |
18 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 $53.70 Median $66.07 Typical High $75.86 | Facility | 52 · Reduced service | $53.70 | $66.07 | $75.86 |
Aetna Setting Facility Modifier 55 · Aftercare only Typical Low $16.22 Median $19.95 Typical High $22.91 | Facility | 55 · Aftercare only | $16.22 | $19.95 | $22.91 |
Aetna Setting Facility Modifier 56 · Pre-op care only Typical Low $10.72 Median $13.18 Typical High $15.14 | Facility | 56 · Pre-op care only | $10.72 | $13.18 | $15.14 |
Aetna Setting Professional Modifier 52 · Reduced service Typical Low $53.70 Median $64.57 Typical High $70.79 | Professional | 52 · Reduced service | $53.70 | $64.57 | $70.79 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $16.22 Median $19.05 Typical High $21.38 | Professional | 55 · Aftercare only | $16.22 | $19.05 | $21.38 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $10.72 Median $12.88 Typical High $14.13 | Professional | 56 · Pre-op care only | $10.72 | $12.88 | $14.13 |
Ambetter Setting Professional Modifier 24 · Unrelated visit after surgery Typical Low $323.59 Median $323.59 Typical High $323.59 | Professional | 24 · Unrelated visit after surgery | $323.59 | $323.59 | $323.59 |
Ambetter Setting Professional Modifier 25 · Same-day visit Typical Low $138.04 Median $186.21 Typical High $309.03 | Professional | 25 · Same-day visit | $138.04 | $186.21 | $309.03 |
Ambetter Setting Professional Modifier 57 · Decision for surgery Typical Low $169.82 Median $223.87 Typical High $323.59 | Professional | 57 · Decision for surgery | $169.82 | $223.87 | $323.59 |
Ambetter Setting Professional Modifier 93 · Audio-only telehealth Typical Low $109.65 Median $331.13 Typical High $331.13 | Professional | 93 · Audio-only telehealth | $109.65 | $331.13 | $331.13 |
Ambetter Setting Professional Modifier FP · Family planning Typical Low $165.96 Median $169.82 Typical High $190.55 | Professional | FP · Family planning | $165.96 | $169.82 | $190.55 |
Ambetter Setting Professional Modifier GC · Resident with teaching physician Typical Low $186.21 Median $223.87 Typical High $281.84 | Professional | GC · Resident with teaching physician | $186.21 | $223.87 | $281.84 |
Ambetter Setting Professional Modifier Q6 · Substitute physician, paid per time Typical Low $169.82 Median $169.82 Typical High $281.84 | Professional | Q6 · Substitute physician, paid per time | $169.82 | $169.82 | $281.84 |
Ambetter Setting Professional Modifier SA · Nurse practitioner Typical Low $144.54 Median $144.54 Typical High $323.59 | Professional | SA · Nurse practitioner | $144.54 | $144.54 | $323.59 |
Ambetter Setting Professional Modifier TR · School services, out of district Typical Low $165.96 Median $165.96 Typical High $165.96 | Professional | TR · School services, out of district | $165.96 | $165.96 | $165.96 |
Ambetter Setting Professional Modifier UD · State-defined Typical Low $144.54 Median $144.54 Typical High $144.54 | Professional | UD · State-defined | $144.54 | $144.54 | $144.54 |
Anthem BCBS Setting Professional Modifier 25 · Same-day visit Typical Low $125.89 Median $125.89 Typical High $125.89 | Professional | 25 · Same-day visit | $125.89 | $125.89 | $125.89 |
Anthem BCBS Setting Professional Modifier EP · Child screening program Typical Low $109.65 Median $109.65 Typical High $165.96 | Professional | EP · Child screening program | $109.65 | $109.65 | $165.96 |
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· 20th of 51
$162
AK $263AL $115
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.