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 $69.18 Median $100.00 Typical High $102.33 | Facility | None | $69.18 | $100.00 | $102.33 |
Aetna Setting Professional Modifier None Typical Low $69.18 Median $100.00 Typical High $208.93 | Professional | None | $69.18 | $100.00 | $208.93 |
Ambetter Setting Professional Modifier None Typical Low $107.15 Median $165.96 Typical High $204.17 | Professional | None | $107.15 | $165.96 | $204.17 |
Anthem BCBS Setting Professional Modifier None Typical Low $69.18 Median $102.33 Typical High $169.82 | Professional | None | $69.18 | $102.33 | $169.82 |
CareSource Setting Professional Modifier None Typical Low $100.00 Median $128.82 Typical High $158.49 | Professional | None | $100.00 | $128.82 | $158.49 |
Cigna Setting Professional Modifier None Typical Low $74.13 Median $112.20 Typical High $245.47 | Professional | None | $74.13 | $112.20 | $245.47 |
Kaiser Permanente Setting Professional Modifier None Typical Low $63.10 Median $107.15 Typical High $194.98 | Professional | None | $63.10 | $107.15 | $194.98 |
Oscar Health Setting Professional Modifier None Typical Low $109.65 Median $144.54 Typical High $229.09 | Professional | None | $109.65 | $144.54 | $229.09 |
United Setting Professional Modifier None Typical Low $70.79 Median $112.20 Typical High $213.80 | Professional | None | $70.79 | $112.20 | $213.80 |
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 $34.67 Median $44.67 Typical High $53.70 | Professional | 52 · Reduced service | $34.67 | $44.67 | $53.70 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $10.23 Median $13.80 Typical High $16.22 | Professional | 55 · Aftercare only | $10.23 | $13.80 | $16.22 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $6.92 Median $9.12 Typical High $10.72 | Professional | 56 · Pre-op care only | $6.92 | $9.12 | $10.72 |
Ambetter Setting Professional Modifier 25 · Same-day visit Typical Low $102.33 Median $117.49 Typical High $204.17 | Professional | 25 · Same-day visit | $102.33 | $117.49 | $204.17 |
Ambetter Setting Professional Modifier EP · Child screening program Typical Low $97.72 Median $109.65 Typical High $173.78 | Professional | EP · Child screening program | $97.72 | $109.65 | $173.78 |
Anthem BCBS Setting Professional Modifier EP · Child screening program Typical Low $67.61 Median $67.61 Typical High $107.15 | Professional | EP · Child screening program | $67.61 | $67.61 | $107.15 |
Where Georgia 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.
Georgia· 25th 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.