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 $60.26 Median $104.71 Typical High $154.88 | Facility | None | $60.26 | $104.71 | $154.88 |
Aetna Setting Professional Modifier None Typical Low $60.26 Median $85.11 Typical High $117.49 | Professional | None | $60.26 | $85.11 | $117.49 |
Ambetter Setting Professional Modifier None Typical Low $97.72 Median $114.82 Typical High $186.21 | Professional | None | $97.72 | $114.82 | $186.21 |
Anthem BCBS Setting Professional Modifier None Typical Low $70.79 Median $102.33 Typical High $134.90 | Professional | None | $70.79 | $102.33 | $134.90 |
BCBS Kansas City Setting Professional Modifier None Typical Low $74.13 Median $117.49 Typical High $141.25 | Professional | None | $74.13 | $117.49 | $141.25 |
Cigna Setting Professional Modifier None Typical Low $77.62 Median $109.65 Typical High $169.82 | Professional | None | $77.62 | $109.65 | $169.82 |
Medica Setting Facility Modifier None Typical Low $85.11 Median $147.91 Typical High $371.54 | Facility | None | $85.11 | $147.91 | $371.54 |
Medica Setting Professional Modifier None Typical Low $112.20 Median $524.81 Typical High $741.31 | Professional | None | $112.20 | $524.81 | $741.31 |
Qualchoice Setting Professional Modifier None Typical Low $128.82 Median $128.82 Typical High $151.36 | Professional | None | $128.82 | $128.82 | $151.36 |
United Setting Professional Modifier None Typical Low $77.62 Median $107.15 Typical High $141.25 | Professional | None | $77.62 | $107.15 | $141.25 |
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 $30.20 Median $42.66 Typical High $53.70 | Professional | 52 · Reduced service | $30.20 | $42.66 | $53.70 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $9.12 Median $12.88 Typical High $15.85 | Professional | 55 · Aftercare only | $9.12 | $12.88 | $15.85 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $6.03 Median $8.71 Typical High $10.72 | Professional | 56 · Pre-op care only | $6.03 | $8.71 | $10.72 |
Ambetter Setting Professional Modifier 25 · Same-day visit Typical Low $114.82 Median $120.23 Typical High $158.49 | Professional | 25 · Same-day visit | $114.82 | $120.23 | $158.49 |
Ambetter Setting Professional Modifier EP · Child screening program Typical Low $70.79 Median $120.23 Typical High $138.04 | Professional | EP · Child screening program | $70.79 | $120.23 | $138.04 |
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· 33rd of 51
$107
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.