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 $74.13 Median $104.71 Typical High $107.15 | Facility | None | $74.13 | $104.71 | $107.15 |
Aetna Setting Professional Modifier None Typical Low $74.13 Median $104.71 Typical High $223.87 | Professional | None | $74.13 | $104.71 | $223.87 |
Ambetter Setting Professional Modifier None Typical Low $112.20 Median $208.93 Typical High $251.19 | Professional | None | $112.20 | $208.93 | $251.19 |
Anthem BCBS Setting Professional Modifier None Typical Low $72.44 Median $107.15 Typical High $181.97 | Professional | None | $72.44 | $107.15 | $181.97 |
CareSource Setting Professional Modifier None Typical Low $104.71 Median $134.90 Typical High $165.96 | Professional | None | $104.71 | $134.90 | $165.96 |
Cigna Setting Professional Modifier None Typical Low $83.18 Median $117.49 Typical High $257.04 | Professional | None | $83.18 | $117.49 | $257.04 |
Kaiser Permanente Setting Professional Modifier None Typical Low $67.61 Median $112.20 Typical High $346.74 | Professional | None | $67.61 | $112.20 | $346.74 |
Oscar Health Setting Professional Modifier None Typical Low $117.49 Median $154.88 Typical High $239.88 | Professional | None | $117.49 | $154.88 | $239.88 |
United Setting Professional Modifier None Typical Low $75.86 Median $117.49 Typical High $223.87 | Professional | None | $75.86 | $117.49 | $223.87 |
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 $36.31 Median $46.77 Typical High $56.23 | Professional | 52 · Reduced service | $36.31 | $46.77 | $56.23 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $10.96 Median $14.13 Typical High $16.98 | Professional | 55 · Aftercare only | $10.96 | $14.13 | $16.98 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $7.41 Median $9.55 Typical High $11.22 | Professional | 56 · Pre-op care only | $7.41 | $9.55 | $11.22 |
Ambetter Setting Professional Modifier 25 · Same-day visit Typical Low $107.15 Median $120.23 Typical High $213.80 | Professional | 25 · Same-day visit | $107.15 | $120.23 | $213.80 |
Ambetter Setting Professional Modifier EP · Child screening program Typical Low $125.89 Median $128.82 Typical High $173.78 | Professional | EP · Child screening program | $125.89 | $128.82 | $173.78 |
Anthem BCBS Setting Professional Modifier EP · Child screening program Typical Low $67.61 Median $67.61 Typical High $112.20 | Professional | EP · Child screening program | $67.61 | $67.61 | $112.20 |
Where Georgia sits
The same service costs 2.8 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· 26th of 51
$110
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.