How much rates vary
Facilitymedian $36 · 10th to 90th $26 to $50Professionalmedian $36 · 10th to 90th $21 to $59
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 $22.91 Median $36.31 Typical High $47.86 | Facility | None | $22.91 | $36.31 | $47.86 |
Aetna Setting Professional Modifier None Typical Low $22.91 Median $35.48 Typical High $47.86 | Professional | None | $22.91 | $35.48 | $47.86 |
Ambetter Setting Professional Modifier None Typical Low $32.36 Median $53.70 Typical High $75.86 | Professional | None | $32.36 | $53.70 | $75.86 |
Anthem BCBS Setting Professional Modifier None Typical Low $20.89 Median $30.90 Typical High $47.86 | Professional | None | $20.89 | $30.90 | $47.86 |
CareSource Setting Facility Modifier None Typical Low $26.30 Median $33.11 Typical High $45.71 | Facility | None | $26.30 | $33.11 | $45.71 |
CareSource Setting Professional Modifier None Typical Low $48.98 Median $51.29 Typical High $67.61 | Professional | None | $48.98 | $51.29 | $67.61 |
Cigna Setting Facility Modifier None Typical Low $50.12 Median $50.12 Typical High $95.50 | Facility | None | $50.12 | $50.12 | $95.50 |
Cigna Setting Professional Modifier None Typical Low $26.30 Median $41.69 Typical High $288.40 | Professional | None | $26.30 | $41.69 | $288.40 |
Molina Setting Professional Modifier None Typical Low $30.90 Median $33.11 Typical High $33.11 | Professional | None | $30.90 | $33.11 | $33.11 |
United Setting Professional Modifier None Typical Low $21.88 Median $34.67 Typical High $53.70 | Professional | None | $21.88 | $34.67 | $53.70 |
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 $15.49 Median $21.38 Typical High $23.99 | Facility | 52 · Reduced service | $15.49 | $21.38 | $23.99 |
Aetna Setting Facility Modifier 55 · Aftercare only Typical Low $4.57 Median $6.46 Typical High $7.24 | Facility | 55 · Aftercare only | $4.57 | $6.46 | $7.24 |
Aetna Setting Facility Modifier 56 · Pre-op care only Typical Low $3.09 Median $4.27 Typical High $4.79 | Facility | 56 · Pre-op care only | $3.09 | $4.27 | $4.79 |
Aetna Setting Professional Modifier 52 · Reduced service Typical Low $13.80 Median $19.50 Typical High $23.99 | Professional | 52 · Reduced service | $13.80 | $19.50 | $23.99 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $4.17 Median $5.89 Typical High $7.24 | Professional | 55 · Aftercare only | $4.17 | $5.89 | $7.24 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $2.75 Median $3.89 Typical High $4.79 | Professional | 56 · Pre-op care only | $2.75 | $3.89 | $4.79 |
Ambetter Setting Professional Modifier 24 · Unrelated visit after surgery Typical Low $54.95 Median $54.95 Typical High $67.61 | Professional | 24 · Unrelated visit after surgery | $54.95 | $54.95 | $67.61 |
Ambetter Setting Professional Modifier 25 · Same-day visit Typical Low $30.20 Median $47.86 Typical High $83.18 | Professional | 25 · Same-day visit | $30.20 | $47.86 | $83.18 |
Ambetter Setting Professional Modifier 93 · Audio-only telehealth Typical Low $46.77 Median $56.23 Typical High $56.23 | Professional | 93 · Audio-only telehealth | $46.77 | $56.23 | $56.23 |
Ambetter Setting Professional Modifier GC · Resident with teaching physician Typical Low $38.02 Median $56.23 Typical High $69.18 | Professional | GC · Resident with teaching physician | $38.02 | $56.23 | $69.18 |
Ambetter Setting Professional Modifier SA · Nurse practitioner Typical Low $30.90 Median $47.86 Typical High $50.12 | Professional | SA · Nurse practitioner | $30.90 | $47.86 | $50.12 |
Where Kentucky 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.
Kentucky· 46th 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.