How much rates vary
Facilitymedian $46 · 10th to 90th $22 to $151Professionalmedian $36 · 10th to 90th $22 to $60
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 $20.89 Median $34.67 Typical High $45.71 | Facility | None | $20.89 | $34.67 | $45.71 |
Aetna Setting Professional Modifier None Typical Low $21.88 Median $33.88 Typical High $47.86 | Professional | None | $21.88 | $33.88 | $47.86 |
Ambetter Setting Professional Modifier None Typical Low $26.92 Median $52.48 Typical High $64.57 | Professional | None | $26.92 | $52.48 | $64.57 |
AvMed Setting Facility Modifier None Typical Low $31.62 Median $48.98 Typical High $64.57 | Facility | None | $31.62 | $48.98 | $64.57 |
AvMed Setting Professional Modifier None Typical Low $26.92 Median $45.71 Typical High $64.57 | Professional | None | $26.92 | $45.71 | $64.57 |
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 $25.12 Median $38.90 Typical High $54.95 | Professional | None | $25.12 | $38.90 | $54.95 |
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 $19.50 Median $39.81 Typical High $141.25 | Professional | None | $19.50 | $39.81 | $141.25 |
Molina Setting Professional Modifier None Typical Low $23.44 Median $46.77 Typical High $138.04 | Professional | None | $23.44 | $46.77 | $138.04 |
United Setting Professional Modifier None Typical Low $19.05 Median $33.11 Typical High $58.88 | Professional | None | $19.05 | $33.11 | $58.88 |
Wellpoint Setting Professional Modifier None Typical Low $19.05 Median $28.18 Typical High $28.18 | Professional | None | $19.05 | $28.18 | $28.18 |
20 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 $10.47 Median $13.49 Typical High $18.20 | Facility | 52 · Reduced service | $10.47 | $13.49 | $18.20 |
Aetna Setting Facility Modifier 55 · Aftercare only Typical Low $3.09 Median $4.07 Typical High $5.50 | Facility | 55 · Aftercare only | $3.09 | $4.07 | $5.50 |
Aetna Setting Facility Modifier 56 · Pre-op care only Typical Low $2.09 Median $2.69 Typical High $3.63 | Facility | 56 · Pre-op care only | $2.09 | $2.69 | $3.63 |
Aetna Setting Facility Modifier AF · Specialist physician Typical Low $38.02 Median $38.90 Typical High $45.71 | Facility | AF · Specialist physician | $38.02 | $38.90 | $45.71 |
Aetna Setting Facility Modifier HO · Master's level Typical Low $28.18 Median $28.84 Typical High $34.67 | Facility | HO · Master's level | $28.18 | $28.84 | $34.67 |
Aetna Setting Facility Modifier TD · Registered nurse Typical Low $32.36 Median $33.11 Typical High $38.90 | Facility | TD · Registered nurse | $32.36 | $33.11 | $38.90 |
Aetna Setting Professional Modifier 52 · Reduced service Typical Low $10.47 Median $16.22 Typical High $19.50 | Professional | 52 · Reduced service | $10.47 | $16.22 | $19.50 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $3.09 Median $4.79 Typical High $5.89 | Professional | 55 · Aftercare only | $3.09 | $4.79 | $5.89 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $2.09 Median $3.24 Typical High $3.80 | Professional | 56 · Pre-op care only | $2.09 | $3.24 | $3.80 |
Aetna Setting Professional Modifier AF · Specialist physician Typical Low $34.67 Median $45.71 Typical High $69.18 | Professional | AF · Specialist physician | $34.67 | $45.71 | $69.18 |
Aetna Setting Professional Modifier HO · Master's level Typical Low $28.84 Median $38.02 Typical High $51.29 | Professional | HO · Master's level | $28.84 | $38.02 | $51.29 |
Aetna Setting Professional Modifier TD · Registered nurse Typical Low $33.11 Median $42.66 Typical High $58.88 | Professional | TD · Registered nurse | $33.11 | $42.66 | $58.88 |
Ambetter Setting Professional Modifier 24 · Unrelated visit after surgery Typical Low $50.12 Median $61.66 Typical High $64.57 | Professional | 24 · Unrelated visit after surgery | $50.12 | $61.66 | $64.57 |
Ambetter Setting Professional Modifier 25 · Same-day visit Typical Low $34.67 Median $56.23 Typical High $64.57 | Professional | 25 · Same-day visit | $34.67 | $56.23 | $64.57 |
Ambetter Setting Professional Modifier 93 · Audio-only telehealth Typical Low $54.95 Median $64.57 Typical High $75.86 | Professional | 93 · Audio-only telehealth | $54.95 | $64.57 | $75.86 |
Ambetter Setting Professional Modifier AF · Specialist physician Typical Low $58.88 Median $58.88 Typical High $58.88 | Professional | AF · Specialist physician | $58.88 | $58.88 | $58.88 |
Ambetter Setting Professional Modifier GC · Resident with teaching physician Typical Low $46.77 Median $58.88 Typical High $75.86 | Professional | GC · Resident with teaching physician | $46.77 | $58.88 | $75.86 |
Ambetter Setting Professional Modifier GE · Resident, primary care exception Typical Low $46.77 Median $46.77 Typical High $46.77 | Professional | GE · Resident, primary care exception | $46.77 | $46.77 | $46.77 |
Ambetter Setting Professional Modifier Q6 · Substitute physician, paid per time Typical Low $31.62 Median $31.62 Typical High $58.88 | Professional | Q6 · Substitute physician, paid per time | $31.62 | $31.62 | $58.88 |
Ambetter Setting Professional Modifier SA · Nurse practitioner Typical Low $58.88 Median $58.88 Typical High $58.88 | Professional | SA · Nurse practitioner | $58.88 | $58.88 | $58.88 |
Where Florida sits
The same service costs 2.4 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· 45th of 51
$36.31
AK $77.62NJ $32.36
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.