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 $56.23 Median $74.13 Typical High $107.15 | Facility | None | $56.23 | $74.13 | $107.15 |
Aetna Setting Professional Modifier None Typical Low $56.23 Median $81.28 Typical High $107.15 | Professional | None | $56.23 | $81.28 | $107.15 |
Aetna Setting Professional Modifier 52 · Reduced service Typical Low $28.18 Median $40.74 Typical High $53.70 | Professional | 52 · Reduced service | $28.18 | $40.74 | $53.70 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $8.51 Median $12.30 Typical High $15.85 | Professional | 55 · Aftercare only | $8.51 | $12.30 | $15.85 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $5.62 Median $8.13 Typical High $10.72 | Professional | 56 · Pre-op care only | $5.62 | $8.13 | $10.72 |
Ambetter Setting Professional Modifier None Typical Low $47.86 Median $93.33 Typical High $117.49 | Professional | None | $47.86 | $93.33 | $117.49 |
BCBS Mississippi Setting Facility Modifier None Typical Low $83.18 Median $85.11 Typical High $85.11 | Facility | None | $83.18 | $85.11 | $85.11 |
BCBS Mississippi Setting Professional Modifier None Typical Low $87.10 Median $100.00 Typical High $100.00 | Professional | None | $87.10 | $100.00 | $100.00 |
Cigna Setting Professional Modifier None Typical Low $57.54 Median $75.86 Typical High $104.71 | Professional | None | $57.54 | $75.86 | $104.71 |
Molina Setting Professional Modifier None Typical Low $21.38 Median $25.12 Typical High $102.33 | Professional | None | $21.38 | $25.12 | $102.33 |
United Setting Professional Modifier None Typical Low $60.26 Median $81.28 Typical High $102.33 | Professional | None | $60.26 | $81.28 | $102.33 |
2 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 $79.43 Median $93.33 Typical High $112.20 | Professional | 25 · Same-day visit | $79.43 | $93.33 | $112.20 |
Ambetter Setting Professional Modifier EP · Child screening program Typical Low $79.43 Median $100.00 Typical High $125.89 | Professional | EP · Child screening program | $79.43 | $100.00 | $125.89 |
Where Mississippi 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.
Mississippi· 35th of 51
$83.18
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.