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 $87.10 Median $120.23 Typical High $123.03 | Facility | None | $87.10 | $120.23 | $123.03 |
Aetna Setting Professional Modifier None Typical Low $87.10 Median $120.23 Typical High $257.04 | Professional | None | $87.10 | $120.23 | $257.04 |
Ambetter Setting Professional Modifier None Typical Low $109.65 Median $144.54 Typical High $245.47 | Professional | None | $109.65 | $144.54 | $245.47 |
Anthem BCBS Setting Professional Modifier None Typical Low $87.10 Median $123.03 Typical High $199.53 | Professional | None | $87.10 | $123.03 | $199.53 |
CareSource Setting Professional Modifier None Typical Low $117.49 Median $154.88 Typical High $190.55 | Professional | None | $117.49 | $154.88 | $190.55 |
Cigna Setting Professional Modifier None Typical Low $93.33 Median $131.83 Typical High $295.12 | Professional | None | $93.33 | $131.83 | $295.12 |
Kaiser Permanente Setting Professional Modifier None Typical Low $81.28 Median $128.82 Typical High $245.47 | Professional | None | $81.28 | $128.82 | $245.47 |
Oscar Health Setting Professional Modifier None Typical Low $128.82 Median $154.88 Typical High $269.15 | Professional | None | $128.82 | $154.88 | $269.15 |
United Setting Professional Modifier None Typical Low $91.20 Median $134.90 Typical High $251.19 | Professional | None | $91.20 | $134.90 | $251.19 |
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 Professional Modifier 52 · Reduced service Typical Low $43.65 Median $51.29 Typical High $63.10 | Professional | 52 · Reduced service | $43.65 | $51.29 | $63.10 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $13.18 Median $15.49 Typical High $19.05 | Professional | 55 · Aftercare only | $13.18 | $15.49 | $19.05 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $8.71 Median $10.72 Typical High $12.88 | Professional | 56 · Pre-op care only | $8.71 | $10.72 | $12.88 |
Ambetter Setting Professional Modifier 25 · Same-day visit Typical Low $109.65 Median $141.25 Typical High $281.84 | Professional | 25 · Same-day visit | $109.65 | $141.25 | $281.84 |
Ambetter Setting Professional Modifier EP · Child screening program Typical Low $128.82 Median $138.04 Typical High $138.04 | Professional | EP · Child screening program | $128.82 | $138.04 | $138.04 |
Ambetter Setting Professional Modifier FP · Family planning Typical Low $169.82 Median $186.21 Typical High $257.04 | Professional | FP · Family planning | $169.82 | $186.21 | $257.04 |
Ambetter Setting Professional Modifier GC · Resident with teaching physician Typical Low $154.88 Median $154.88 Typical High $154.88 | Professional | GC · Resident with teaching physician | $154.88 | $154.88 | $154.88 |
Anthem BCBS Setting Professional Modifier EP · Child screening program Typical Low $75.86 Median $75.86 Typical High $128.82 | Professional | EP · Child screening program | $75.86 | $75.86 | $128.82 |
Where Georgia sits
The same service costs 2.7 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· 22nd of 51
$126
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.