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 $63.10 Median $91.20 Typical High $93.33 | Facility | None | $63.10 | $91.20 | $93.33 |
Aetna Setting Professional Modifier None Typical Low $63.10 Median $91.20 Typical High $190.55 | Professional | None | $63.10 | $91.20 | $190.55 |
Ambetter Setting Professional Modifier None Typical Low $97.72 Median $109.65 Typical High $186.21 | Professional | None | $97.72 | $109.65 | $186.21 |
Anthem BCBS Setting Professional Modifier None Typical Low $63.10 Median $93.33 Typical High $154.88 | Professional | None | $63.10 | $93.33 | $154.88 |
CareSource Setting Professional Modifier None Typical Low $89.13 Median $114.82 Typical High $141.25 | Professional | None | $89.13 | $114.82 | $141.25 |
Cigna Setting Professional Modifier None Typical Low $64.57 Median $100.00 Typical High $223.87 | Professional | None | $64.57 | $100.00 | $223.87 |
Kaiser Permanente Setting Professional Modifier None Typical Low $57.54 Median $97.72 Typical High $134.90 | Professional | None | $57.54 | $97.72 | $134.90 |
Oscar Health Setting Professional Modifier None Typical Low $100.00 Median $131.83 Typical High $204.17 | Professional | None | $100.00 | $131.83 | $204.17 |
United Setting Professional Modifier None Typical Low $61.66 Median $100.00 Typical High $186.21 | Professional | None | $61.66 | $100.00 | $186.21 |
7 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 $31.62 Median $38.90 Typical High $47.86 | Professional | 52 · Reduced service | $31.62 | $38.90 | $47.86 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $9.33 Median $11.75 Typical High $14.45 | Professional | 55 · Aftercare only | $9.33 | $11.75 | $14.45 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $6.31 Median $8.13 Typical High $9.55 | Professional | 56 · Pre-op care only | $6.31 | $8.13 | $9.55 |
Ambetter Setting Professional Modifier 25 · Same-day visit Typical Low $83.18 Median $107.15 Typical High $199.53 | Professional | 25 · Same-day visit | $83.18 | $107.15 | $199.53 |
Ambetter Setting Professional Modifier EP · Child screening program Typical Low $89.13 Median $100.00 Typical High $218.78 | Professional | EP · Child screening program | $89.13 | $100.00 | $218.78 |
Ambetter Setting Professional Modifier SA · Nurse practitioner Typical Low $100.00 Median $100.00 Typical High $100.00 | Professional | SA · Nurse practitioner | $100.00 | $100.00 | $100.00 |
Anthem BCBS Setting Professional Modifier EP · Child screening program Typical Low $67.61 Median $67.61 Typical High $100.00 | Professional | EP · Child screening program | $67.61 | $67.61 | $100.00 |
Where Georgia 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.
Georgia· 22nd of 51
$93.33
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.