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 $47.86 Median $77.62 Typical High $102.33 | Facility | None | $47.86 | $77.62 | $102.33 |
Aetna Setting Professional Modifier None Typical Low $47.86 Median $58.88 Typical High $100.00 | Professional | None | $47.86 | $58.88 | $100.00 |
Ambetter Setting Professional Modifier None Typical Low $72.44 Median $87.10 Typical High $114.82 | Professional | None | $72.44 | $87.10 | $114.82 |
Anthem BCBS Setting Professional Modifier None Typical Low $67.61 Median $83.18 Typical High $120.23 | Professional | None | $67.61 | $83.18 | $120.23 |
BCBS Kansas City Setting Professional Modifier None Typical Low $72.44 Median $75.86 Typical High $107.15 | Professional | None | $72.44 | $75.86 | $107.15 |
Cigna Setting Professional Modifier None Typical Low $72.44 Median $83.18 Typical High $141.25 | Professional | None | $72.44 | $83.18 | $141.25 |
Medica Setting Facility Modifier None Typical Low $87.10 Median $107.15 Typical High $363.08 | Facility | None | $87.10 | $107.15 | $363.08 |
Medica Setting Professional Modifier None Typical Low $66.07 Median $199.53 Typical High $478.63 | Professional | None | $66.07 | $199.53 | $478.63 |
United Setting Professional Modifier None Typical Low $61.66 Median $77.62 Typical High $123.03 | Professional | None | $61.66 | $77.62 | $123.03 |
6 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 $28.18 Median $33.88 Typical High $34.67 | Professional | 52 · Reduced service | $28.18 | $33.88 | $34.67 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $8.51 Median $10.23 Typical High $10.47 | Professional | 55 · Aftercare only | $8.51 | $10.23 | $10.47 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $5.62 Median $6.92 Typical High $7.08 | Professional | 56 · Pre-op care only | $5.62 | $6.92 | $7.08 |
Ambetter Setting Professional Modifier 25 · Same-day visit Typical Low $72.44 Median $85.11 Typical High $114.82 | Professional | 25 · Same-day visit | $72.44 | $85.11 | $114.82 |
Ambetter Setting Professional Modifier FS · Shared visit Typical Low $87.10 Median $114.82 Typical High $114.82 | Professional | FS · Shared visit | $87.10 | $114.82 | $114.82 |
Ambetter Setting Professional Modifier GC · Resident with teaching physician Typical Low $74.13 Median $114.82 Typical High $114.82 | Professional | GC · Resident with teaching physician | $74.13 | $114.82 | $114.82 |
Where Missouri sits
The same service costs 2.3 times more in Alaska than in New Jersey. 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.
Missouri· 25th of 51
$83.18
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.