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 $57.54 Median $100.00 Typical High $158.49 | Facility | None | $57.54 | $100.00 | $158.49 |
Aetna Setting Professional Modifier None Typical Low $57.54 Median $83.18 Typical High $114.82 | Professional | None | $57.54 | $83.18 | $114.82 |
Ambetter Setting Professional Modifier None Typical Low $93.33 Median $109.65 Typical High $151.36 | Professional | None | $93.33 | $109.65 | $151.36 |
Anthem BCBS Setting Professional Modifier None Typical Low $67.61 Median $97.72 Typical High $131.83 | Professional | None | $67.61 | $97.72 | $131.83 |
BCBS Kansas City Setting Professional Modifier None Typical Low $69.18 Median $114.82 Typical High $138.04 | Professional | None | $69.18 | $114.82 | $138.04 |
Cigna Setting Professional Modifier None Typical Low $74.13 Median $107.15 Typical High $162.18 | Professional | None | $74.13 | $107.15 | $162.18 |
Medica Setting Facility Modifier None Typical Low $81.28 Median $147.91 Typical High $354.81 | Facility | None | $81.28 | $147.91 | $354.81 |
Medica Setting Professional Modifier None Typical Low $107.15 Median $501.19 Typical High $707.95 | Professional | None | $107.15 | $501.19 | $707.95 |
Qualchoice Setting Professional Modifier None Typical Low $144.54 Median $144.54 Typical High $144.54 | Professional | None | $144.54 | $144.54 | $144.54 |
United Setting Professional Modifier None Typical Low $72.44 Median $102.33 Typical High $138.04 | Professional | None | $72.44 | $102.33 | $138.04 |
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 $28.84 Median $41.69 Typical High $51.29 | Professional | 52 · Reduced service | $28.84 | $41.69 | $51.29 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $8.71 Median $12.30 Typical High $15.49 | Professional | 55 · Aftercare only | $8.71 | $12.30 | $15.49 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $5.75 Median $8.32 Typical High $10.23 | Professional | 56 · Pre-op care only | $5.75 | $8.32 | $10.23 |
Ambetter Setting Professional Modifier 25 · Same-day visit Typical Low $109.65 Median $114.82 Typical High $177.83 | Professional | 25 · Same-day visit | $109.65 | $114.82 | $177.83 |
Ambetter Setting Professional Modifier EP · Child screening program Typical Low $107.15 Median $125.89 Typical High $131.83 | Professional | EP · Child screening program | $107.15 | $125.89 | $131.83 |
Where Missouri 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.
Missouri· 29th 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.