How much rates vary
Facilitymedian $40 · 10th to 90th $28 to $151Professionalmedian $46 · 10th to 90th $28 to $91
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 $28.18 Median $37.15 Typical High $46.77 | Facility | None | $28.18 | $37.15 | $46.77 |
Aetna Setting Professional Modifier None Typical Low $28.18 Median $39.81 Typical High $74.13 | Professional | None | $28.18 | $39.81 | $74.13 |
Ambetter Setting Professional Modifier None Typical Low $33.11 Median $58.88 Typical High $97.72 | Professional | None | $33.11 | $58.88 | $97.72 |
Anthem BCBS Setting Professional Modifier None Typical Low $27.54 Median $44.67 Typical High $72.44 | Professional | None | $27.54 | $44.67 | $72.44 |
CareSource Setting Professional Modifier None Typical Low $51.29 Median $66.07 Typical High $81.28 | Professional | None | $51.29 | $66.07 | $81.28 |
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 $25.70 Median $45.71 Typical High $117.49 | Professional | None | $25.70 | $45.71 | $117.49 |
Kaiser Permanente Setting Professional Modifier None Typical Low $31.62 Median $60.26 Typical High $79.43 | Professional | None | $31.62 | $60.26 | $79.43 |
Oscar Health Setting Professional Modifier None Typical Low $36.31 Median $61.66 Typical High $117.49 | Professional | None | $36.31 | $61.66 | $117.49 |
United Setting Professional Modifier None Typical Low $25.70 Median $45.71 Typical High $97.72 | Professional | None | $25.70 | $45.71 | $97.72 |
19 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 $14.13 Median $19.50 Typical High $25.12 | Facility | 52 · Reduced service | $14.13 | $19.50 | $25.12 |
Aetna Setting Facility Modifier 55 · Aftercare only Typical Low $4.27 Median $5.89 Typical High $7.59 | Facility | 55 · Aftercare only | $4.27 | $5.89 | $7.59 |
Aetna Setting Facility Modifier 56 · Pre-op care only Typical Low $2.82 Median $3.89 Typical High $5.13 | Facility | 56 · Pre-op care only | $2.82 | $3.89 | $5.13 |
Aetna Setting Professional Modifier 52 · Reduced service Typical Low $14.13 Median $17.78 Typical High $23.44 | Professional | 52 · Reduced service | $14.13 | $17.78 | $23.44 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $4.27 Median $5.25 Typical High $6.92 | Professional | 55 · Aftercare only | $4.27 | $5.25 | $6.92 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $2.82 Median $3.55 Typical High $4.68 | Professional | 56 · Pre-op care only | $2.82 | $3.55 | $4.68 |
Ambetter Setting Professional Modifier 24 · Unrelated visit after surgery Typical Low $50.12 Median $85.11 Typical High $114.82 | Professional | 24 · Unrelated visit after surgery | $50.12 | $85.11 | $114.82 |
Ambetter Setting Professional Modifier 25 · Same-day visit Typical Low $47.86 Median $63.10 Typical High $107.15 | Professional | 25 · Same-day visit | $47.86 | $63.10 | $107.15 |
Ambetter Setting Professional Modifier 57 · Decision for surgery Typical Low $107.15 Median $107.15 Typical High $107.15 | Professional | 57 · Decision for surgery | $107.15 | $107.15 | $107.15 |
Ambetter Setting Professional Modifier 93 · Audio-only telehealth Typical Low $51.29 Median $77.62 Typical High $114.82 | Professional | 93 · Audio-only telehealth | $51.29 | $77.62 | $114.82 |
Ambetter Setting Professional Modifier EP · Child screening program Typical Low $56.23 Median $60.26 Typical High $60.26 | Professional | EP · Child screening program | $56.23 | $60.26 | $60.26 |
Ambetter Setting Professional Modifier FP · Family planning Typical Low $34.67 Median $46.77 Typical High $63.10 | Professional | FP · Family planning | $34.67 | $46.77 | $63.10 |
Ambetter Setting Professional Modifier GY · Excluded by law Typical Low $50.12 Median $50.12 Typical High $50.12 | Professional | GY · Excluded by law | $50.12 | $50.12 | $50.12 |
Ambetter Setting Professional Modifier Q6 · Substitute physician, paid per time Typical Low $95.50 Median $95.50 Typical High $114.82 | Professional | Q6 · Substitute physician, paid per time | $95.50 | $95.50 | $114.82 |
Ambetter Setting Professional Modifier SA · Nurse practitioner Typical Low $107.15 Median $107.15 Typical High $107.15 | Professional | SA · Nurse practitioner | $107.15 | $107.15 | $107.15 |
Ambetter Setting Professional Modifier U1 · State-defined Typical Low $30.90 Median $60.26 Typical High $60.26 | Professional | U1 · State-defined | $30.90 | $60.26 | $60.26 |
Ambetter Setting Professional Modifier U2 · State-defined Typical Low $22.39 Median $30.90 Typical High $30.90 | Professional | U2 · State-defined | $22.39 | $30.90 | $30.90 |
Anthem BCBS Setting Professional Modifier 25 · Same-day visit Typical Low $34.67 Median $34.67 Typical High $34.67 | Professional | 25 · Same-day visit | $34.67 | $34.67 | $34.67 |
Anthem BCBS Setting Professional Modifier EP · Child screening program Typical Low $29.51 Median $29.51 Typical High $45.71 | Professional | EP · Child screening program | $29.51 | $29.51 | $45.71 |
Where Georgia 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.
Georgia· 22nd of 51
$45.71
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.