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 $75.86 Median $104.71 Typical High $154.88 | Facility | None | $75.86 | $104.71 | $154.88 |
Aetna Setting Professional Modifier None Typical Low $63.10 Median $85.11 Typical High $120.23 | Professional | None | $63.10 | $85.11 | $120.23 |
Ambetter Setting Professional Modifier None Typical Low $93.33 Median $112.20 Typical High $158.49 | Professional | None | $93.33 | $112.20 | $158.49 |
Anthem BCBS Setting Professional Modifier None Typical Low $74.13 Median $102.33 Typical High $131.83 | Professional | None | $74.13 | $102.33 | $131.83 |
BCBS Kansas City Setting Professional Modifier None Typical Low $75.86 Median $117.49 Typical High $141.25 | Professional | None | $75.86 | $117.49 | $141.25 |
Cigna Setting Professional Modifier None Typical Low $81.28 Median $109.65 Typical High $165.96 | Professional | None | $81.28 | $109.65 | $165.96 |
Medica Setting Facility Modifier None Typical Low $79.43 Median $131.83 Typical High $389.05 | Facility | None | $79.43 | $131.83 | $389.05 |
Medica Setting Professional Modifier None Typical Low $104.71 Median $537.03 Typical High $724.44 | Professional | None | $104.71 | $537.03 | $724.44 |
Qualchoice Setting Professional Modifier None Typical Low $147.91 Median $147.91 Typical High $208.93 | Professional | None | $147.91 | $147.91 | $208.93 |
United Setting Professional Modifier None Typical Low $79.43 Median $104.71 Typical High $141.25 | Professional | None | $79.43 | $104.71 | $141.25 |
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 $31.62 Median $42.66 Typical High $52.48 | Professional | 52 · Reduced service | $31.62 | $42.66 | $52.48 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $9.33 Median $12.88 Typical High $15.85 | Professional | 55 · Aftercare only | $9.33 | $12.88 | $15.85 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $6.31 Median $8.51 Typical High $10.47 | Professional | 56 · Pre-op care only | $6.31 | $8.51 | $10.47 |
Ambetter Setting Professional Modifier 25 · Same-day visit Typical Low $95.50 Median $117.49 Typical High $165.96 | Professional | 25 · Same-day visit | $95.50 | $117.49 | $165.96 |
Ambetter Setting Professional Modifier CG · Policy criteria applied Typical Low $100.00 Median $100.00 Typical High $100.00 | Professional | CG · Policy criteria applied | $100.00 | $100.00 | $100.00 |
Ambetter Setting Professional Modifier EP · Child screening program Typical Low $114.82 Median $128.82 Typical High $128.82 | Professional | EP · Child screening program | $114.82 | $128.82 | $128.82 |
Medica Setting Professional Modifier 25 · Same-day visit Typical Low $112.20 Median $138.04 Typical High $154.88 | Professional | 25 · Same-day visit | $112.20 | $138.04 | $154.88 |
Where Missouri 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.
Missouri· 30th of 51
$107
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.