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 $85.11 Median $85.11 Typical High $85.11 | Facility | None | $85.11 | $85.11 | $85.11 |
Aetna Setting Professional Modifier None Typical Low $58.88 Median $81.28 Typical High $85.11 | Professional | None | $58.88 | $81.28 | $85.11 |
Aetna Setting Professional Modifier 52 · Reduced service Typical Low $29.51 Median $37.15 Typical High $42.66 | Professional | 52 · Reduced service | $29.51 | $37.15 | $42.66 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $8.91 Median $11.22 Typical High $12.88 | Professional | 55 · Aftercare only | $8.91 | $11.22 | $12.88 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $5.89 Median $7.41 Typical High $8.51 | Professional | 56 · Pre-op care only | $5.89 | $7.41 | $8.51 |
Ambetter Setting Professional Modifier None Typical Low $81.28 Median $95.50 Typical High $95.50 | Professional | None | $81.28 | $95.50 | $95.50 |
Cigna Setting Professional Modifier None Typical Low $51.29 Median $63.10 Typical High $85.11 | Professional | None | $51.29 | $63.10 | $85.11 |
United Setting Professional Modifier None Typical Low $54.95 Median $69.18 Typical High $95.50 | Professional | None | $54.95 | $69.18 | $95.50 |
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 $83.18 Median $104.71 Typical High $114.82 | Professional | 25 · Same-day visit | $83.18 | $104.71 | $114.82 |
Ambetter Setting Professional Modifier EP · Child screening program Typical Low $81.28 Median $81.28 Typical High $104.71 | Professional | EP · Child screening program | $81.28 | $81.28 | $104.71 |
BCBS Alabama Setting Professional Modifier 12 + 32 · Mandated service Typical Low $51.29 Median $70.79 Typical High $102.33 | Professional | 12 + 32 · Mandated service | $51.29 | $70.79 | $102.33 |
Where Alabama sits
The same service costs 2.9 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
$72.44
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.