How much rates vary
Distribution of negotiated rates across all payers (price axis is log-scale). Small sample; interpret with caution. 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 $109.65 Median $109.65 Typical High $131.83 | Facility | None | $109.65 | $109.65 | $131.83 |
Aetna Setting Professional Modifier None Typical Low $79.43 Median $109.65 Typical High $147.91 | Professional | None | $79.43 | $109.65 | $147.91 |
Ambetter Setting Professional Modifier None Typical Low $69.18 Median $81.28 Typical High $154.88 | Professional | None | $69.18 | $81.28 | $154.88 |
CareSource Setting Professional Modifier None Typical Low $107.15 Median $107.15 Typical High $107.15 | Professional | None | $107.15 | $107.15 | $107.15 |
Cigna Setting Professional Modifier None Typical Low $61.66 Median $95.50 Typical High $138.04 | Professional | None | $61.66 | $95.50 | $138.04 |
Qualchoice Setting Professional Modifier None Typical Low $79.43 Median $100.00 Typical High $177.83 | Professional | None | $79.43 | $100.00 | $177.83 |
United Setting Professional Modifier None Typical Low $79.43 Median $97.72 Typical High $141.25 | Professional | None | $79.43 | $97.72 | $141.25 |
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 $39.81 Median $53.70 Typical High $53.70 | Professional | 52 · Reduced service | $39.81 | $53.70 | $53.70 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $12.02 Median $16.22 Typical High $16.22 | Professional | 55 · Aftercare only | $12.02 | $16.22 | $16.22 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $7.94 Median $10.96 Typical High $10.96 | Professional | 56 · Pre-op care only | $7.94 | $10.96 | $10.96 |
Ambetter Setting Professional Modifier 25 · Same-day visit Typical Low $81.28 Median $93.33 Typical High $128.82 | Professional | 25 · Same-day visit | $81.28 | $93.33 | $128.82 |
Ambetter Setting Professional Modifier AI · Physician of record Typical Low $81.28 Median $81.28 Typical High $128.82 | Professional | AI · Physician of record | $81.28 | $81.28 | $128.82 |
Ambetter Setting Professional Modifier FS · Shared visit Typical Low $81.28 Median $81.28 Typical High $128.82 | Professional | FS · Shared visit | $81.28 | $81.28 | $128.82 |
Qualchoice Setting Professional Modifier 25 · Same-day visit Typical Low $93.33 Median $93.33 Typical High $125.89 | Professional | 25 · Same-day visit | $93.33 | $93.33 | $125.89 |
Qualchoice Setting Professional Modifier AI · Physician of record Typical Low $93.33 Median $93.33 Typical High $147.91 | Professional | AI · Physician of record | $93.33 | $93.33 | $147.91 |
Qualchoice Setting Professional Modifier FS · Shared visit Typical Low $93.33 Median $93.33 Typical High $147.91 | Professional | FS · Shared visit | $93.33 | $93.33 | $147.91 |
Where Arkansas 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.
Arkansas· 24th of 51
$110
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.