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 $48.98 Median $77.62 Typical High $117.49 | Facility | None | $48.98 | $77.62 | $117.49 |
Aetna Setting Professional Modifier None Typical Low $48.98 Median $70.79 Typical High $97.72 | Professional | None | $48.98 | $70.79 | $97.72 |
Ambetter Setting Professional Modifier None Typical Low $81.28 Median $100.00 Typical High $144.54 | Professional | None | $81.28 | $100.00 | $144.54 |
Anthem BCBS Setting Professional Modifier None Typical Low $57.54 Median $85.11 Typical High $107.15 | Professional | None | $57.54 | $85.11 | $107.15 |
BCBS Kansas City Setting Professional Modifier None Typical Low $58.88 Median $97.72 Typical High $117.49 | Professional | None | $58.88 | $97.72 | $117.49 |
Cigna Setting Professional Modifier None Typical Low $61.66 Median $89.13 Typical High $138.04 | Professional | None | $61.66 | $89.13 | $138.04 |
Medica Setting Facility Modifier None Typical Low $69.18 Median $112.20 Typical High $302.00 | Facility | None | $69.18 | $112.20 | $302.00 |
Medica Setting Professional Modifier None Typical Low $87.10 Median $426.58 Typical High $616.60 | Professional | None | $87.10 | $426.58 | $616.60 |
Qualchoice Setting Professional Modifier None Typical Low $125.89 Median $125.89 Typical High $125.89 | Professional | None | $125.89 | $125.89 | $125.89 |
United Setting Professional Modifier None Typical Low $61.66 Median $87.10 Typical High $117.49 | Professional | None | $61.66 | $87.10 | $117.49 |
6 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 $24.55 Median $35.48 Typical High $43.65 | Professional | 52 · Reduced service | $24.55 | $35.48 | $43.65 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $7.41 Median $10.72 Typical High $13.18 | Professional | 55 · Aftercare only | $7.41 | $10.72 | $13.18 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $4.90 Median $7.08 Typical High $8.71 | Professional | 56 · Pre-op care only | $4.90 | $7.08 | $8.71 |
Ambetter Setting Professional Modifier 25 · Same-day visit Typical Low $93.33 Median $100.00 Typical High $144.54 | Professional | 25 · Same-day visit | $93.33 | $100.00 | $144.54 |
Ambetter Setting Professional Modifier EP · Child screening program Typical Low $93.33 Median $95.50 Typical High $138.04 | Professional | EP · Child screening program | $93.33 | $95.50 | $138.04 |
Medica Setting Professional Modifier 25 · Same-day visit Typical Low $107.15 Median $120.23 Typical High $169.82 | Professional | 25 · Same-day visit | $107.15 | $120.23 | $169.82 |
Where Missouri 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.
Missouri· 29th of 51
$87.10
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.