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 $67.61 Median $95.50 Typical High $123.03 | Facility | None | $67.61 | $95.50 | $123.03 |
Aetna Setting Professional Modifier None Typical Low $67.61 Median $91.20 Typical High $107.15 | Professional | None | $67.61 | $91.20 | $107.15 |
Ambetter Setting Professional Modifier None Typical Low $117.49 Median $120.23 Typical High $138.04 | Professional | None | $117.49 | $120.23 | $138.04 |
Anthem BCBS Setting Professional Modifier None Typical Low $72.44 Median $95.50 Typical High $125.89 | Professional | None | $72.44 | $95.50 | $125.89 |
CareSource Setting Facility Modifier None Typical Low $75.86 Median $120.23 Typical High $218.78 | Facility | None | $75.86 | $120.23 | $218.78 |
CareSource Setting Professional Modifier None Typical Low $107.15 Median $109.65 Typical High $141.25 | Professional | None | $107.15 | $109.65 | $141.25 |
Cigna Setting Facility Modifier None Typical Low $102.33 Median $102.33 Typical High $102.33 | Facility | None | $102.33 | $102.33 | $102.33 |
Cigna Setting Professional Modifier None Typical Low $75.86 Median $109.65 Typical High $602.56 | Professional | None | $75.86 | $109.65 | $602.56 |
Molina Setting Professional Modifier None Typical Low $67.61 Median $89.13 Typical High $93.33 | Professional | None | $67.61 | $89.13 | $93.33 |
United Setting Professional Modifier None Typical Low $70.79 Median $97.72 Typical High $123.03 | Professional | None | $70.79 | $97.72 | $123.03 |
8 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 Facility Modifier 52 · Reduced service Typical Low $33.88 Median $47.86 Typical High $61.66 | Facility | 52 · Reduced service | $33.88 | $47.86 | $61.66 |
Aetna Setting Facility Modifier 55 · Aftercare only Typical Low $10.23 Median $14.13 Typical High $18.62 | Facility | 55 · Aftercare only | $10.23 | $14.13 | $18.62 |
Aetna Setting Facility Modifier 56 · Pre-op care only Typical Low $6.76 Median $9.55 Typical High $12.30 | Facility | 56 · Pre-op care only | $6.76 | $9.55 | $12.30 |
Aetna Setting Professional Modifier 52 · Reduced service Typical Low $33.88 Median $45.71 Typical High $53.70 | Professional | 52 · Reduced service | $33.88 | $45.71 | $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 $6.76 Median $9.12 Typical High $10.72 | Professional | 56 · Pre-op care only | $6.76 | $9.12 | $10.72 |
Ambetter Setting Professional Modifier 25 · Same-day visit Typical Low $100.00 Median $123.03 Typical High $144.54 | Professional | 25 · Same-day visit | $100.00 | $123.03 | $144.54 |
Ambetter Setting Professional Modifier EP · Child screening program Typical Low $117.49 Median $117.49 Typical High $117.49 | Professional | EP · Child screening program | $117.49 | $117.49 | $117.49 |
Where Kentucky 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.
Kentucky· 45th of 51
$95.50
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.