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 $4.37 Median $4.37 Typical High $7.24 | Facility | None | $4.37 | $4.37 | $7.24 |
Aetna Setting Professional Modifier None Typical Low $4.37 Median $5.75 Typical High $7.24 | Professional | None | $4.37 | $5.75 | $7.24 |
Aetna Setting Professional Modifier 52 · Reduced service Typical Low $2.19 Median $2.95 Typical High $3.63 | Professional | 52 · Reduced service | $2.19 | $2.95 | $3.63 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $0.87 Median $1.20 Typical High $1.45 | Professional | 53 · Discontinued | $0.87 | $1.20 | $1.45 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $0.66 Median $0.89 Typical High $1.10 | Professional | 55 · Aftercare only | $0.66 | $0.89 | $1.10 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $0.44 Median $0.59 Typical High $0.72 | Professional | 56 · Pre-op care only | $0.44 | $0.59 | $0.72 |
Ambetter Setting Professional Modifier None Typical Low $3.24 Median $4.37 Typical High $5.75 | Professional | None | $3.24 | $4.37 | $5.75 |
BCBS Mississippi Setting Facility Modifier None Typical Low $58.88 Median $58.88 Typical High $58.88 | Facility | None | $58.88 | $58.88 | $58.88 |
BCBS Mississippi Setting Professional Modifier None Typical Low $6.03 Median $6.03 Typical High $6.03 | Professional | None | $6.03 | $6.03 | $6.03 |
Cigna Setting Professional Modifier None Typical Low $3.02 Median $5.01 Typical High $5.75 | Professional | None | $3.02 | $5.01 | $5.75 |
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 Facility Modifier None Typical Low $46.77 Median $67.61 Typical High $75.86 | Facility | None | $46.77 | $67.61 | $75.86 |
United Setting Professional Modifier None Typical Low $4.17 Median $5.13 Typical High $7.76 | Professional | None | $4.17 | $5.13 | $7.76 |
2 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 59 · Distinct service Typical Low $3.63 Median $4.27 Typical High $4.37 | Professional | 59 · Distinct service | $3.63 | $4.27 | $4.37 |
Ambetter Setting Professional Modifier EP · Child screening program Typical Low $4.27 Median $5.37 Typical High $5.75 | Professional | EP · Child screening program | $4.27 | $5.37 | $5.75 |
Where Mississippi sits
The same service costs 2.7 times more in North Dakota than in New Mexico. 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· 13th of 51
$6.03
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.