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 $75.86 Median $77.62 Typical High $107.15 | Facility | None | $75.86 | $77.62 | $107.15 |
Aetna Setting Professional Modifier None Typical Low $74.13 Median $85.11 Typical High $107.15 | Professional | None | $74.13 | $85.11 | $107.15 |
Aetna Setting Professional Modifier 52 · Reduced service Typical Low $38.02 Median $39.81 Typical High $53.70 | Professional | 52 · Reduced service | $38.02 | $39.81 | $53.70 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $11.22 Median $12.02 Typical High $15.85 | Professional | 55 · Aftercare only | $11.22 | $12.02 | $15.85 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $7.59 Median $7.94 Typical High $10.72 | Professional | 56 · Pre-op care only | $7.59 | $7.94 | $10.72 |
Ambetter Setting Professional Modifier None Typical Low $102.33 Median $117.49 Typical High $120.23 | Professional | None | $102.33 | $117.49 | $120.23 |
BCBS Arkansas Setting Professional Modifier None Typical Low $144.54 Median $144.54 Typical High $144.54 | Professional | None | $144.54 | $144.54 | $144.54 |
CareSource Setting Professional Modifier None Typical Low $97.72 Median $141.25 Typical High $162.18 | Professional | None | $97.72 | $141.25 | $162.18 |
Cigna Setting Professional Modifier None Typical Low $70.79 Median $102.33 Typical High $125.89 | Professional | None | $70.79 | $102.33 | $125.89 |
Qualchoice Setting Professional Modifier None Typical Low $117.49 Median $138.04 Typical High $138.04 | Professional | None | $117.49 | $138.04 | $138.04 |
United Setting Professional Modifier None Typical Low $63.10 Median $89.13 Typical High $120.23 | Professional | None | $63.10 | $89.13 | $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 $104.71 Median $109.65 Typical High $117.49 | Professional | 25 · Same-day visit | $104.71 | $109.65 | $117.49 |
Ambetter Setting Professional Modifier EP · Child screening program Typical Low $120.23 Median $120.23 Typical High $120.23 | Professional | EP · Child screening program | $120.23 | $120.23 | $120.23 |
Qualchoice Setting Professional Modifier 25 · Same-day visit Typical Low $125.89 Median $134.90 Typical High $134.90 | Professional | 25 · Same-day visit | $125.89 | $134.90 | $134.90 |
Qualchoice Setting Professional Modifier EP · Child screening program Typical Low $138.04 Median $138.04 Typical High $138.04 | Professional | EP · Child screening program | $138.04 | $138.04 | $138.04 |
Where Arkansas sits
The same service costs 2.9 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.
Arkansas· 22nd of 51
$105
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.