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 $79.43 Median $93.33 Typical High $120.23 | Facility | None | $79.43 | $93.33 | $120.23 |
Aetna Setting Professional Modifier None Typical Low $89.13 Median $112.20 Typical High $154.88 | Professional | None | $89.13 | $112.20 | $154.88 |
Aetna Setting Professional Modifier 52 · Reduced service Typical Low $39.81 Median $52.48 Typical High $64.57 | Professional | 52 · Reduced service | $39.81 | $52.48 | $64.57 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $12.02 Median $15.49 Typical High $19.05 | Professional | 55 · Aftercare only | $12.02 | $15.49 | $19.05 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $7.94 Median $10.47 Typical High $12.88 | Professional | 56 · Pre-op care only | $7.94 | $10.47 | $12.88 |
Ambetter Setting Professional Modifier None Typical Low $123.03 Median $154.88 Typical High $165.96 | Professional | None | $123.03 | $154.88 | $165.96 |
AvMed Setting Facility Modifier None Typical Low $64.57 Median $64.57 Typical High $64.57 | Facility | None | $64.57 | $64.57 | $64.57 |
AvMed Setting Professional Modifier None Typical Low $64.57 Median $102.33 Typical High $169.82 | Professional | None | $64.57 | $102.33 | $169.82 |
Cigna Setting Facility Modifier None Typical Low $141.25 Median $141.25 Typical High $141.25 | Facility | None | $141.25 | $141.25 | $141.25 |
Cigna Setting Professional Modifier None Typical Low $79.43 Median $102.33 Typical High $169.82 | Professional | None | $79.43 | $102.33 | $169.82 |
Florida Blue Setting Professional Modifier None Typical Low $58.88 Median $125.89 Typical High $165.96 | Professional | None | $58.88 | $125.89 | $165.96 |
Molina Setting Professional Modifier None Typical Low $85.11 Median $131.83 Typical High $199.53 | Professional | None | $85.11 | $131.83 | $199.53 |
United Setting Professional Modifier None Typical Low $70.79 Median $109.65 Typical High $169.82 | Professional | None | $70.79 | $109.65 | $169.82 |
Wellpoint Setting Professional Modifier None Typical Low $77.62 Median $120.23 Typical High $120.23 | Professional | None | $77.62 | $120.23 | $120.23 |
4 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 |
|---|---|---|---|---|---|
Ambetter Setting Professional Modifier 25 · Same-day visit Typical Low $123.03 Median $151.36 Typical High $165.96 | Professional | 25 · Same-day visit | $123.03 | $151.36 | $165.96 |
Ambetter Setting Professional Modifier GC · Resident with teaching physician Typical Low $97.72 Median $141.25 Typical High $190.55 | Professional | GC · Resident with teaching physician | $97.72 | $141.25 | $190.55 |
Ambetter Setting Professional Modifier GY · Excluded by law Typical Low $75.86 Median $75.86 Typical High $75.86 | Professional | GY · Excluded by law | $75.86 | $75.86 | $75.86 |
Ambetter Setting Professional Modifier Q6 · Substitute physician, paid per time Typical Low $151.36 Median $151.36 Typical High $151.36 | Professional | Q6 · Substitute physician, paid per time | $151.36 | $151.36 | $151.36 |
Where Florida sits
The same service costs 2.7 times more in Alaska than in Washington, DC. 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· 50th of 51
$112
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.