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 $69.18 Median $114.82 Typical High $169.82 | Facility | None | $69.18 | $114.82 | $169.82 |
Aetna Setting Professional Modifier None Typical Low $69.18 Median $93.33 Typical High $131.83 | Professional | None | $69.18 | $93.33 | $131.83 |
Ambetter Setting Professional Modifier None Typical Low $95.50 Median $125.89 Typical High $173.78 | Professional | None | $95.50 | $125.89 | $173.78 |
Anthem BCBS Setting Professional Modifier None Typical Low $81.28 Median $112.20 Typical High $147.91 | Professional | None | $81.28 | $112.20 | $147.91 |
BCBS Kansas City Setting Professional Modifier None Typical Low $83.18 Median $128.82 Typical High $154.88 | Professional | None | $83.18 | $128.82 | $154.88 |
Cigna Setting Professional Modifier None Typical Low $89.13 Median $123.03 Typical High $186.21 | Professional | None | $89.13 | $123.03 | $186.21 |
Medica Setting Facility Modifier None Typical Low $95.50 Median $162.18 Typical High $426.58 | Facility | None | $95.50 | $162.18 | $426.58 |
Medica Setting Professional Modifier None Typical Low $123.03 Median $602.56 Typical High $812.83 | Professional | None | $123.03 | $602.56 | $812.83 |
United Setting Professional Modifier None Typical Low $87.10 Median $117.49 Typical High $158.49 | Professional | None | $87.10 | $117.49 | $158.49 |
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 $34.67 Median $46.77 Typical High $58.88 | Professional | 52 · Reduced service | $34.67 | $46.77 | $58.88 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $10.23 Median $14.13 Typical High $17.38 | Professional | 55 · Aftercare only | $10.23 | $14.13 | $17.38 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $6.92 Median $9.33 Typical High $11.75 | Professional | 56 · Pre-op care only | $6.92 | $9.33 | $11.75 |
Ambetter Setting Professional Modifier 25 · Same-day visit Typical Low $109.65 Median $125.89 Typical High $194.98 | Professional | 25 · Same-day visit | $109.65 | $125.89 | $194.98 |
Ambetter Setting Professional Modifier 33 · Preventive service Typical Low $173.78 Median $173.78 Typical High $173.78 | Professional | 33 · Preventive service | $173.78 | $173.78 | $173.78 |
Ambetter Setting Professional Modifier EP · Child screening program Typical Low $128.82 Median $131.83 Typical High $151.36 | Professional | EP · Child screening program | $128.82 | $131.83 | $151.36 |
Ambetter Setting Professional Modifier GE · Resident, primary care exception Typical Low $141.25 Median $141.25 Typical High $141.25 | Professional | GE · Resident, primary care exception | $141.25 | $141.25 | $141.25 |
Qualchoice Setting Professional Modifier 25 · Same-day visit Typical Low $141.25 Median $141.25 Typical High $165.96 | Professional | 25 · Same-day visit | $141.25 | $141.25 | $165.96 |
Where Missouri 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.
Missouri· 34th of 51
$117
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.