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 $125.89 Median $125.89 Typical High $125.89 | Facility | None | $125.89 | $125.89 | $125.89 |
Aetna Setting Professional Modifier None Typical Low $74.13 Median $97.72 Typical High $102.33 | Professional | None | $74.13 | $97.72 | $102.33 |
Aetna Setting Professional Modifier 52 · Reduced service Typical Low $36.31 Median $44.67 Typical High $51.29 | Professional | 52 · Reduced service | $36.31 | $44.67 | $51.29 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $10.96 Median $13.49 Typical High $15.49 | Professional | 55 · Aftercare only | $10.96 | $13.49 | $15.49 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $7.41 Median $8.91 Typical High $10.23 | Professional | 56 · Pre-op care only | $7.41 | $8.91 | $10.23 |
Ambetter Setting Professional Modifier None Typical Low $97.72 Median $117.49 Typical High $123.03 | Professional | None | $97.72 | $117.49 | $123.03 |
Cigna Setting Professional Modifier None Typical Low $72.44 Median $79.43 Typical High $107.15 | Professional | None | $72.44 | $79.43 | $107.15 |
United Setting Professional Modifier None Typical Low $67.61 Median $91.20 Typical High $117.49 | Professional | None | $67.61 | $91.20 | $117.49 |
3 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 $97.72 Median $114.82 Typical High $114.82 | Professional | 25 · Same-day visit | $97.72 | $114.82 | $114.82 |
Ambetter Setting Professional Modifier EP · Child screening program Typical Low $97.72 Median $97.72 Typical High $97.72 | Professional | EP · Child screening program | $97.72 | $97.72 | $97.72 |
BCBS Alabama Setting Professional Modifier 12 + 32 · Mandated service Typical Low $83.18 Median $114.82 Typical High $151.36 | Professional | 12 + 32 · Mandated service | $83.18 | $114.82 | $151.36 |
Where Alabama 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.
Alabama· 48th of 51
$89.13
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.