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 $85.11 Median $151.36 Typical High $9,120.11 | Facility | None | $85.11 | $151.36 | $9,120.11 |
Aetna Setting Professional Modifier None Typical Low $75.86 Median $91.20 Typical High $154.88 | Professional | None | $75.86 | $91.20 | $154.88 |
Ambetter Setting Professional Modifier None Typical Low $100.00 Median $123.03 Typical High $151.36 | Professional | None | $100.00 | $123.03 | $151.36 |
Anthem BCBS Setting Professional Modifier None Typical Low $102.33 Median $123.03 Typical High $194.98 | Professional | None | $102.33 | $123.03 | $194.98 |
BCBS Kansas City Setting Professional Modifier None Typical Low $100.00 Median $128.82 Typical High $162.18 | Professional | None | $100.00 | $128.82 | $162.18 |
Cigna Setting Facility Modifier None Typical Low $3,715.35 Median $3,715.35 Typical High $3,715.35 | Facility | None | $3,715.35 | $3,715.35 | $3,715.35 |
Cigna Setting Professional Modifier None Typical Low $100.00 Median $117.49 Typical High $204.17 | Professional | None | $100.00 | $117.49 | $204.17 |
Medica Setting Facility Modifier None Typical Low $104.71 Median $165.96 Typical High $478.63 | Facility | None | $104.71 | $165.96 | $478.63 |
Medica Setting Professional Modifier None Typical Low $112.20 Median $676.08 Typical High $1,174.90 | Professional | None | $112.20 | $676.08 | $1,174.90 |
Qualchoice Setting Professional Modifier None Typical Low $125.89 Median $125.89 Typical High $125.89 | Professional | None | $125.89 | $125.89 | $125.89 |
United Setting Professional Modifier None Typical Low $93.33 Median $112.20 Typical High $169.82 | Professional | None | $93.33 | $112.20 | $169.82 |
5 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 $38.02 Median $42.66 Typical High $52.48 | Professional | 52 · Reduced service | $38.02 | $42.66 | $52.48 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $11.22 Median $12.88 Typical High $15.49 | Professional | 55 · Aftercare only | $11.22 | $12.88 | $15.49 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $7.59 Median $8.51 Typical High $10.47 | Professional | 56 · Pre-op care only | $7.59 | $8.51 | $10.47 |
Ambetter Setting Professional Modifier 25 · Same-day visit Typical Low $109.65 Median $151.36 Typical High $162.18 | Professional | 25 · Same-day visit | $109.65 | $151.36 | $162.18 |
Ambetter Setting Professional Modifier GC · Resident with teaching physician Typical Low $100.00 Median $100.00 Typical High $100.00 | Professional | GC · Resident with teaching physician | $100.00 | $100.00 | $100.00 |
Where Missouri sits
The same service costs 2.7 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· 26th of 51
$123
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.