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 $89.13 Median $218.78 Typical High $309.03 | Facility | None | $89.13 | $218.78 | $309.03 |
Aetna Setting Professional Modifier None Typical Low $64.57 Median $89.13 Typical High $158.49 | Professional | None | $64.57 | $89.13 | $158.49 |
Ambetter Setting Professional Modifier None Typical Low $75.86 Median $109.65 Typical High $138.04 | Professional | None | $75.86 | $109.65 | $138.04 |
Anthem BCBS Setting Professional Modifier None Typical Low $63.10 Median $81.28 Typical High $117.49 | Professional | None | $63.10 | $81.28 | $117.49 |
Aultcare Setting Professional Modifier None Typical Low $125.89 Median $125.89 Typical High $194.98 | Professional | None | $125.89 | $125.89 | $194.98 |
CareSource Setting Facility Modifier None Typical Low $77.62 Median $120.23 Typical High $158.49 | Facility | None | $77.62 | $120.23 | $158.49 |
CareSource Setting Professional Modifier None Typical Low $104.71 Median $112.20 Typical High $165.96 | Professional | None | $104.71 | $112.20 | $165.96 |
Cigna Setting Professional Modifier None Typical Low $79.43 Median $104.71 Typical High $147.91 | Professional | None | $79.43 | $104.71 | $147.91 |
Medical Mutual of Ohio Setting Professional Modifier None Typical Low $81.28 Median $128.82 Typical High $251.19 | Professional | None | $81.28 | $128.82 | $251.19 |
Molina Setting Professional Modifier None Typical Low $39.81 Median $74.13 Typical High $147.91 | Professional | None | $39.81 | $74.13 | $147.91 |
SummaCare Setting Professional Modifier None Typical Low $72.44 Median $97.72 Typical High $120.23 | Professional | None | $72.44 | $97.72 | $120.23 |
United Setting Professional Modifier None Typical Low $63.10 Median $89.13 Typical High $134.90 | Professional | None | $63.10 | $89.13 | $134.90 |
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 $32.36 Median $43.65 Typical High $50.12 | Professional | 52 · Reduced service | $32.36 | $43.65 | $50.12 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $9.77 Median $13.18 Typical High $15.14 | Professional | 55 · Aftercare only | $9.77 | $13.18 | $15.14 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $6.46 Median $8.91 Typical High $10.00 | Professional | 56 · Pre-op care only | $6.46 | $8.91 | $10.00 |
Ambetter Setting Professional Modifier 25 · Same-day visit Typical Low $97.72 Median $114.82 Typical High $134.90 | Professional | 25 · Same-day visit | $97.72 | $114.82 | $134.90 |
Ambetter Setting Professional Modifier EP · Child screening program Typical Low $114.82 Median $114.82 Typical High $114.82 | Professional | EP · Child screening program | $114.82 | $114.82 | $114.82 |
Ambetter Setting Professional Modifier GC · Resident with teaching physician Typical Low $72.44 Median $72.44 Typical High $141.25 | Professional | GC · Resident with teaching physician | $72.44 | $72.44 | $141.25 |
Ambetter Setting Professional Modifier SA · Nurse practitioner Typical Low $97.72 Median $97.72 Typical High $114.82 | Professional | SA · Nurse practitioner | $97.72 | $97.72 | $114.82 |
Where Ohio 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.
Ohio· 40th of 51
$95.50
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.