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 $79.43 Median $107.15 Typical High $109.65 | Facility | None | $79.43 | $107.15 | $109.65 |
Aetna Setting Professional Modifier None Typical Low $79.43 Median $107.15 Typical High $239.88 | Professional | None | $79.43 | $107.15 | $239.88 |
Ambetter Setting Professional Modifier None Typical Low $97.72 Median $128.82 Typical High $223.87 | Professional | None | $97.72 | $128.82 | $223.87 |
Anthem BCBS Setting Professional Modifier None Typical Low $79.43 Median $109.65 Typical High $181.97 | Professional | None | $79.43 | $109.65 | $181.97 |
CareSource Setting Professional Modifier None Typical Low $107.15 Median $138.04 Typical High $169.82 | Professional | None | $107.15 | $138.04 | $169.82 |
Cigna Setting Professional Modifier None Typical Low $85.11 Median $120.23 Typical High $251.19 | Professional | None | $85.11 | $120.23 | $251.19 |
Kaiser Permanente Setting Professional Modifier None Typical Low $74.13 Median $107.15 Typical High $346.74 | Professional | None | $74.13 | $107.15 | $346.74 |
Oscar Health Setting Professional Modifier None Typical Low $128.82 Median $169.82 Typical High $245.47 | Professional | None | $128.82 | $169.82 | $245.47 |
United Setting Professional Modifier None Typical Low $81.28 Median $123.03 Typical High $229.09 | Professional | None | $81.28 | $123.03 | $229.09 |
10 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 $39.81 Median $46.77 Typical High $57.54 | Professional | 52 · Reduced service | $39.81 | $46.77 | $57.54 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $12.02 Median $14.45 Typical High $17.38 | Professional | 55 · Aftercare only | $12.02 | $14.45 | $17.38 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $7.94 Median $9.55 Typical High $11.48 | Professional | 56 · Pre-op care only | $7.94 | $9.55 | $11.48 |
Ambetter Setting Professional Modifier 25 · Same-day visit Typical Low $97.72 Median $128.82 Typical High $234.42 | Professional | 25 · Same-day visit | $97.72 | $128.82 | $234.42 |
Ambetter Setting Professional Modifier 33 · Preventive service Typical Low $229.09 Median $229.09 Typical High $229.09 | Professional | 33 · Preventive service | $229.09 | $229.09 | $229.09 |
Ambetter Setting Professional Modifier EP · Child screening program Typical Low $114.82 Median $177.83 Typical High $234.42 | Professional | EP · Child screening program | $114.82 | $177.83 | $234.42 |
Ambetter Setting Professional Modifier FP · Family planning Typical Low $109.65 Median $257.04 Typical High $257.04 | Professional | FP · Family planning | $109.65 | $257.04 | $257.04 |
Ambetter Setting Professional Modifier GC · Resident with teaching physician Typical Low $141.25 Median $141.25 Typical High $141.25 | Professional | GC · Resident with teaching physician | $141.25 | $141.25 | $141.25 |
Ambetter Setting Professional Modifier SA · Nurse practitioner Typical Low $117.49 Median $117.49 Typical High $117.49 | Professional | SA · Nurse practitioner | $117.49 | $117.49 | $117.49 |
Anthem BCBS Setting Professional Modifier EP · Child screening program Typical Low $75.86 Median $114.82 Typical High $114.82 | Professional | EP · Child screening program | $75.86 | $114.82 | $114.82 |
Where Georgia 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.
Georgia· 23rd of 51
$112
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.