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 $43.65 Median $56.23 Typical High $63.10 | Facility | None | $43.65 | $56.23 | $63.10 |
Aetna Setting Professional Modifier None Typical Low $50.12 Median $63.10 Typical High $89.13 | Professional | None | $50.12 | $63.10 | $89.13 |
Ambetter Setting Professional Modifier None Typical Low $67.61 Median $81.28 Typical High $97.72 | Professional | None | $67.61 | $81.28 | $97.72 |
BCBS Mississippi Setting Facility Modifier None Typical Low $91.20 Median $91.20 Typical High $91.20 | Facility | None | $91.20 | $91.20 | $91.20 |
BCBS Mississippi Setting Professional Modifier None Typical Low $70.79 Median $81.28 Typical High $81.28 | Professional | None | $70.79 | $81.28 | $81.28 |
Cigna Setting Professional Modifier None Typical Low $63.10 Median $75.86 Typical High $93.33 | Professional | None | $63.10 | $75.86 | $93.33 |
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 $61.66 Median $69.18 Typical High $91.20 | Professional | None | $61.66 | $69.18 | $91.20 |
8 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 $29.51 Median $36.31 Typical High $37.15 | Professional | 52 · Reduced service | $29.51 | $36.31 | $37.15 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $8.71 Median $10.96 Typical High $11.22 | Professional | 55 · Aftercare only | $8.71 | $10.96 | $11.22 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $5.89 Median $7.24 Typical High $7.41 | Professional | 56 · Pre-op care only | $5.89 | $7.24 | $7.41 |
Ambetter Setting Professional Modifier 25 · Same-day visit Typical Low $67.61 Median $85.11 Typical High $95.50 | Professional | 25 · Same-day visit | $67.61 | $85.11 | $95.50 |
Ambetter Setting Professional Modifier 57 · Decision for surgery Typical Low $91.20 Median $95.50 Typical High $97.72 | Professional | 57 · Decision for surgery | $91.20 | $95.50 | $97.72 |
Ambetter Setting Professional Modifier FS · Shared visit Typical Low $67.61 Median $91.20 Typical High $102.33 | Professional | FS · Shared visit | $67.61 | $91.20 | $102.33 |
Ambetter Setting Professional Modifier GC · Resident with teaching physician Typical Low $67.61 Median $87.10 Typical High $95.50 | Professional | GC · Resident with teaching physician | $67.61 | $87.10 | $95.50 |
Ambetter Setting Professional Modifier Q6 · Substitute physician, paid per time Typical Low $95.50 Median $95.50 Typical High $107.15 | Professional | Q6 · Substitute physician, paid per time | $95.50 | $95.50 | $107.15 |
Where Mississippi sits
The same service costs 2.4 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.
Mississippi· 43rd of 51
$72.44
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.