How much rates vary
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 $22.39 Median $30.20 Typical High $43.65 | Facility | None | $22.39 | $30.20 | $43.65 |
Aetna Setting Professional Modifier None Typical Low $24.55 Median $33.11 Typical High $51.29 | Professional | None | $24.55 | $33.11 | $51.29 |
Ambetter Setting Professional Modifier None Typical Low $25.12 Median $50.12 Typical High $70.79 | Professional | None | $25.12 | $50.12 | $70.79 |
BCBS Mississippi Setting Facility Modifier None Typical Low $45.71 Median $45.71 Typical High $128.82 | Facility | None | $45.71 | $45.71 | $128.82 |
BCBS Mississippi Setting Professional Modifier None Typical Low $50.12 Median $56.23 Typical High $56.23 | Professional | None | $50.12 | $56.23 | $56.23 |
Cigna Setting Facility Modifier None Typical Low $109.65 Median $109.65 Typical High $141.25 | Facility | None | $109.65 | $109.65 | $141.25 |
Cigna Setting Professional Modifier None Typical Low $24.55 Median $39.81 Typical High $53.70 | Professional | None | $24.55 | $39.81 | $53.70 |
Molina Setting Professional Modifier None Typical Low $33.11 Median $33.11 Typical High $33.11 | Professional | None | $33.11 | $33.11 | $33.11 |
United Setting Professional Modifier None Typical Low $22.39 Median $36.31 Typical High $51.29 | Professional | None | $22.39 | $36.31 | $51.29 |
9 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 Professional Modifier 52 · Reduced service Typical Low $12.88 Median $19.50 Typical High $25.70 | Professional | 52 · Reduced service | $12.88 | $19.50 | $25.70 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $3.89 Median $5.75 Typical High $7.76 | Professional | 55 · Aftercare only | $3.89 | $5.75 | $7.76 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $2.57 Median $3.89 Typical High $5.13 | Professional | 56 · Pre-op care only | $2.57 | $3.89 | $5.13 |
Ambetter Setting Professional Modifier 24 · Unrelated visit after surgery Typical Low $53.70 Median $61.66 Typical High $61.66 | Professional | 24 · Unrelated visit after surgery | $53.70 | $61.66 | $61.66 |
Ambetter Setting Professional Modifier 25 · Same-day visit Typical Low $45.71 Median $53.70 Typical High $67.61 | Professional | 25 · Same-day visit | $45.71 | $53.70 | $67.61 |
Ambetter Setting Professional Modifier 93 · Audio-only telehealth Typical Low $37.15 Median $37.15 Typical High $64.57 | Professional | 93 · Audio-only telehealth | $37.15 | $37.15 | $64.57 |
Ambetter Setting Professional Modifier GC · Resident with teaching physician Typical Low $67.61 Median $67.61 Typical High $67.61 | Professional | GC · Resident with teaching physician | $67.61 | $67.61 | $67.61 |
Ambetter Setting Professional Modifier GE · Resident, primary care exception Typical Low $75.86 Median $75.86 Typical High $75.86 | Professional | GE · Resident, primary care exception | $75.86 | $75.86 | $75.86 |
Ambetter Setting Professional Modifier HW · State mental health funded Typical Low $28.84 Median $28.84 Typical High $28.84 | Professional | HW · State mental health funded | $28.84 | $28.84 | $28.84 |
Where Mississippi 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.
Mississippi· 43rd of 51
$38.90
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.