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 $72.44 Median $95.50 Typical High $128.82 | Facility | None | $72.44 | $95.50 | $128.82 |
Aetna Setting Professional Modifier None Typical Low $72.44 Median $97.72 Typical High $128.82 | Professional | None | $72.44 | $97.72 | $128.82 |
Aetna Setting Professional Modifier 52 · Reduced service Typical Low $36.31 Median $48.98 Typical High $64.57 | Professional | 52 · Reduced service | $36.31 | $48.98 | $64.57 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $10.96 Median $14.79 Typical High $19.05 | Professional | 55 · Aftercare only | $10.96 | $14.79 | $19.05 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $7.24 Median $9.77 Typical High $12.88 | Professional | 56 · Pre-op care only | $7.24 | $9.77 | $12.88 |
Ambetter Setting Professional Modifier None Typical Low $95.50 Median $120.23 Typical High $141.25 | Professional | None | $95.50 | $120.23 | $141.25 |
BCBS Mississippi Setting Facility Modifier None Typical Low $91.20 Median $91.20 Typical High $91.20 | Facility | None | $91.20 | $91.20 | $91.20 |
BCBS Mississippi Setting Professional Modifier None Typical Low $104.71 Median $117.49 Typical High $117.49 | Professional | None | $104.71 | $117.49 | $117.49 |
Cigna Setting Professional Modifier None Typical Low $72.44 Median $95.50 Typical High $128.82 | Professional | None | $72.44 | $95.50 | $128.82 |
Molina Setting Professional Modifier None Typical Low $21.38 Median $25.12 Typical High $120.23 | Professional | None | $21.38 | $25.12 | $120.23 |
United Setting Professional Modifier None Typical Low $77.62 Median $97.72 Typical High $123.03 | Professional | None | $77.62 | $97.72 | $123.03 |
4 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 $100.00 Median $134.90 Typical High $144.54 | Professional | 25 · Same-day visit | $100.00 | $134.90 | $144.54 |
Ambetter Setting Professional Modifier EP · Child screening program Typical Low $112.20 Median $138.04 Typical High $141.25 | Professional | EP · Child screening program | $112.20 | $138.04 | $141.25 |
Ambetter Setting Professional Modifier GC · Resident with teaching physician Typical Low $158.49 Median $158.49 Typical High $158.49 | Professional | GC · Resident with teaching physician | $158.49 | $158.49 | $158.49 |
Ambetter Setting Professional Modifier GE · Resident, primary care exception Typical Low $158.49 Median $158.49 Typical High $158.49 | Professional | GE · Resident, primary care exception | $158.49 | $158.49 | $158.49 |
Where Mississippi 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.
Mississippi· 32nd 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.