How much rates vary
Facilitymedian $85 · 10th to 90th $78 to $138Professionalmedian $91 · 10th to 90th $59 to $174
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 $81.28 Median $87.10 Typical High $138.04 | Facility | None | $81.28 | $87.10 | $138.04 |
Aetna Setting Professional Modifier None Typical Low $72.44 Median $114.82 Typical High $177.83 | Professional | None | $72.44 | $114.82 | $177.83 |
Ambetter Setting Professional Modifier None Typical Low $61.66 Median $85.11 Typical High $371.54 | Professional | None | $61.66 | $85.11 | $371.54 |
AvMed Setting Facility Modifier None Typical Low $64.57 Median $79.43 Typical High $85.11 | Facility | None | $64.57 | $79.43 | $85.11 |
AvMed Setting Professional Modifier None Typical Low $64.57 Median $85.11 Typical High $112.20 | Professional | None | $64.57 | $85.11 | $112.20 |
Cigna Setting Facility Modifier None Typical Low $104.71 Median $104.71 Typical High $104.71 | Facility | None | $104.71 | $104.71 | $104.71 |
Cigna Setting Professional Modifier None Typical Low $58.88 Median $75.86 Typical High $181.97 | Professional | None | $58.88 | $75.86 | $181.97 |
Florida Blue Setting Professional Modifier None Typical Low $53.70 Median $61.66 Typical High $81.28 | Professional | None | $53.70 | $61.66 | $81.28 |
Molina Setting Professional Modifier None Typical Low $53.70 Median $77.62 Typical High $141.25 | Professional | None | $53.70 | $77.62 | $141.25 |
United Setting Professional Modifier None Typical Low $66.07 Median $100.00 Typical High $199.53 | Professional | None | $66.07 | $100.00 | $199.53 |
Wellpoint Setting Professional Modifier None Typical Low $57.54 Median $57.54 Typical High $77.62 | Professional | None | $57.54 | $57.54 | $77.62 |
12 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 $40.74 Median $43.65 Typical High $58.88 | Facility | 52 · Reduced service | $40.74 | $43.65 | $58.88 |
Aetna Setting Facility Modifier 55 · Aftercare only Typical Low $12.30 Median $13.18 Typical High $17.78 | Facility | 55 · Aftercare only | $12.30 | $13.18 | $17.78 |
Aetna Setting Facility Modifier 56 · Pre-op care only Typical Low $8.13 Median $8.71 Typical High $11.75 | Facility | 56 · Pre-op care only | $8.13 | $8.71 | $11.75 |
Aetna Setting Professional Modifier 52 · Reduced service Typical Low $38.02 Median $40.74 Typical High $48.98 | Professional | 52 · Reduced service | $38.02 | $40.74 | $48.98 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $11.48 Median $12.30 Typical High $14.45 | Professional | 55 · Aftercare only | $11.48 | $12.30 | $14.45 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $7.59 Median $8.13 Typical High $9.77 | Professional | 56 · Pre-op care only | $7.59 | $8.13 | $9.77 |
Ambetter Setting Professional Modifier 24 · Unrelated visit after surgery Typical Low $77.62 Median $77.62 Typical High $100.00 | Professional | 24 · Unrelated visit after surgery | $77.62 | $77.62 | $100.00 |
Ambetter Setting Professional Modifier 25 · Same-day visit Typical Low $66.07 Median $79.43 Typical High $109.65 | Professional | 25 · Same-day visit | $66.07 | $79.43 | $109.65 |
Ambetter Setting Professional Modifier 57 · Decision for surgery Typical Low $77.62 Median $81.28 Typical High $114.82 | Professional | 57 · Decision for surgery | $77.62 | $81.28 | $114.82 |
Ambetter Setting Professional Modifier AI · Physician of record Typical Low $63.10 Median $66.07 Typical High $100.00 | Professional | AI · Physician of record | $63.10 | $66.07 | $100.00 |
Ambetter Setting Professional Modifier FS · Shared visit Typical Low $66.07 Median $93.33 Typical High $154.88 | Professional | FS · Shared visit | $66.07 | $93.33 | $154.88 |
Ambetter Setting Professional Modifier GC · Resident with teaching physician Typical Low $77.62 Median $93.33 Typical High $213.80 | Professional | GC · Resident with teaching physician | $77.62 | $93.33 | $213.80 |
Where Florida 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.
Florida· 40th of 51
$89.13
AK $174AL $74.13
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.