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 $120.23 Median $144.54 Typical High $169.82 | Facility | None | $120.23 | $144.54 | $169.82 |
Aetna Setting Professional Modifier None Typical Low $120.23 Median $151.36 Typical High $331.13 | Professional | None | $120.23 | $151.36 | $331.13 |
Ambetter Setting Professional Modifier None Typical Low $154.88 Median $245.47 Typical High $309.03 | Professional | None | $154.88 | $245.47 | $309.03 |
Anthem BCBS Setting Professional Modifier None Typical Low $125.89 Median $147.91 Typical High $257.04 | Professional | None | $125.89 | $147.91 | $257.04 |
CareSource Setting Professional Modifier None Typical Low $147.91 Median $190.55 Typical High $234.42 | Professional | None | $147.91 | $190.55 | $234.42 |
Cigna Setting Professional Modifier None Typical Low $147.91 Median $186.21 Typical High $346.74 | Professional | None | $147.91 | $186.21 | $346.74 |
Kaiser Permanente Setting Professional Modifier None Typical Low $134.90 Median $190.55 Typical High $331.13 | Professional | None | $134.90 | $190.55 | $331.13 |
Oscar Health Setting Professional Modifier None Typical Low $154.88 Median $162.18 Typical High $269.15 | Professional | None | $154.88 | $162.18 | $269.15 |
United Setting Professional Modifier None Typical Low $151.36 Median $204.17 Typical High $323.59 | Professional | None | $151.36 | $204.17 | $323.59 |
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 Facility Modifier 52 · Reduced service Typical Low $63.10 Median $74.13 Typical High $89.13 | Facility | 52 · Reduced service | $63.10 | $74.13 | $89.13 |
Aetna Setting Facility Modifier 55 · Aftercare only Typical Low $18.62 Median $22.39 Typical High $26.92 | Facility | 55 · Aftercare only | $18.62 | $22.39 | $26.92 |
Aetna Setting Facility Modifier 56 · Pre-op care only Typical Low $12.59 Median $14.79 Typical High $18.20 | Facility | 56 · Pre-op care only | $12.59 | $14.79 | $18.20 |
Aetna Setting Professional Modifier 52 · Reduced service Typical Low $63.10 Median $74.13 Typical High $87.10 | Professional | 52 · Reduced service | $63.10 | $74.13 | $87.10 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $18.62 Median $22.39 Typical High $25.70 | Professional | 55 · Aftercare only | $18.62 | $22.39 | $25.70 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $12.59 Median $14.79 Typical High $17.38 | Professional | 56 · Pre-op care only | $12.59 | $14.79 | $17.38 |
Ambetter Setting Professional Modifier 25 · Same-day visit Typical Low $275.42 Median $275.42 Typical High $288.40 | Professional | 25 · Same-day visit | $275.42 | $275.42 | $288.40 |
Anthem BCBS Setting Professional Modifier EP · Child screening program Typical Low $138.04 Median $138.04 Typical High $181.97 | Professional | EP · Child screening program | $138.04 | $138.04 | $181.97 |
Where Georgia 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.
Georgia· 29th of 51
$158
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.