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 $67.61 Median $91.20 Typical High $109.65 | Facility | None | $67.61 | $91.20 | $109.65 |
Aetna Setting Professional Modifier None Typical Low $67.61 Median $89.13 Typical High $104.71 | Professional | None | $67.61 | $89.13 | $104.71 |
Ambetter Setting Professional Modifier None Typical Low $75.86 Median $95.50 Typical High $158.49 | Professional | None | $75.86 | $95.50 | $158.49 |
Anthem BCBS Setting Professional Modifier None Typical Low $70.79 Median $87.10 Typical High $123.03 | Professional | None | $70.79 | $87.10 | $123.03 |
CareSource Setting Facility Modifier None Typical Low $75.86 Median $120.23 Typical High $218.78 | Facility | None | $75.86 | $120.23 | $218.78 |
CareSource Setting Professional Modifier None Typical Low $104.71 Median $107.15 Typical High $134.90 | Professional | None | $104.71 | $107.15 | $134.90 |
Cigna Setting Facility Modifier None Typical Low $102.33 Median $102.33 Typical High $102.33 | Facility | None | $102.33 | $102.33 | $102.33 |
Cigna Setting Professional Modifier None Typical Low $75.86 Median $107.15 Typical High $575.44 | Professional | None | $75.86 | $107.15 | $575.44 |
Molina Setting Professional Modifier None Typical Low $67.61 Median $89.13 Typical High $93.33 | Professional | None | $67.61 | $89.13 | $93.33 |
United Setting Professional Modifier None Typical Low $70.79 Median $91.20 Typical High $120.23 | Professional | None | $70.79 | $91.20 | $120.23 |
9 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 Facility Modifier 52 · Reduced service Typical Low $33.88 Median $45.71 Typical High $54.95 | Facility | 52 · Reduced service | $33.88 | $45.71 | $54.95 |
Aetna Setting Facility Modifier 55 · Aftercare only Typical Low $10.23 Median $13.80 Typical High $16.60 | Facility | 55 · Aftercare only | $10.23 | $13.80 | $16.60 |
Aetna Setting Facility Modifier 56 · Pre-op care only Typical Low $6.76 Median $9.12 Typical High $10.96 | Facility | 56 · Pre-op care only | $6.76 | $9.12 | $10.96 |
Aetna Setting Professional Modifier 52 · Reduced service Typical Low $33.88 Median $43.65 Typical High $52.48 | Professional | 52 · Reduced service | $33.88 | $43.65 | $52.48 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $10.23 Median $13.18 Typical High $15.49 | Professional | 55 · Aftercare only | $10.23 | $13.18 | $15.49 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $6.76 Median $8.91 Typical High $10.47 | Professional | 56 · Pre-op care only | $6.76 | $8.91 | $10.47 |
Ambetter Setting Professional Modifier 25 · Same-day visit Typical Low $102.33 Median $114.82 Typical High $169.82 | Professional | 25 · Same-day visit | $102.33 | $114.82 | $169.82 |
Ambetter Setting Professional Modifier GE · Resident, primary care exception Typical Low $89.13 Median $89.13 Typical High $89.13 | Professional | GE · Resident, primary care exception | $89.13 | $89.13 | $89.13 |
Ambetter Setting Professional Modifier SA · Nurse practitioner Typical Low $95.50 Median $95.50 Typical High $95.50 | Professional | SA · Nurse practitioner | $95.50 | $95.50 | $95.50 |
Where Kentucky 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.
Kentucky· 46th of 51
$89.13
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.