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 $83.18 Median $117.49 Typical High $165.96 | Facility | None | $83.18 | $117.49 | $165.96 |
Aetna Setting Professional Modifier None Typical Low $67.61 Median $89.13 Typical High $128.82 | Professional | None | $67.61 | $89.13 | $128.82 |
Ambetter Setting Professional Modifier None Typical Low $102.33 Median $120.23 Typical High $154.88 | Professional | None | $102.33 | $120.23 | $154.88 |
Anthem BCBS Setting Professional Modifier None Typical Low $79.43 Median $109.65 Typical High $144.54 | Professional | None | $79.43 | $109.65 | $144.54 |
BCBS Kansas City Setting Professional Modifier None Typical Low $81.28 Median $125.89 Typical High $151.36 | Professional | None | $81.28 | $125.89 | $151.36 |
Cigna Setting Professional Modifier None Typical Low $87.10 Median $120.23 Typical High $177.83 | Professional | None | $87.10 | $120.23 | $177.83 |
Medica Setting Facility Modifier None Typical Low $87.10 Median $144.54 Typical High $416.87 | Facility | None | $87.10 | $144.54 | $416.87 |
Medica Setting Professional Modifier None Typical Low $114.82 Median $588.84 Typical High $776.25 | Professional | None | $114.82 | $588.84 | $776.25 |
Qualchoice Setting Professional Modifier None Typical Low $104.71 Median $134.90 Typical High $158.49 | Professional | None | $104.71 | $134.90 | $158.49 |
United Setting Professional Modifier None Typical Low $87.10 Median $112.20 Typical High $151.36 | Professional | None | $87.10 | $112.20 | $151.36 |
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 $33.88 Median $44.67 Typical High $56.23 | Professional | 52 · Reduced service | $33.88 | $44.67 | $56.23 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $10.23 Median $13.49 Typical High $16.60 | Professional | 55 · Aftercare only | $10.23 | $13.49 | $16.60 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $6.76 Median $8.91 Typical High $11.22 | Professional | 56 · Pre-op care only | $6.76 | $8.91 | $11.22 |
Ambetter Setting Professional Modifier 25 · Same-day visit Typical Low $102.33 Median $125.89 Typical High $173.78 | Professional | 25 · Same-day visit | $102.33 | $125.89 | $173.78 |
Ambetter Setting Professional Modifier CG · Policy criteria applied Typical Low $102.33 Median $102.33 Typical High $102.33 | Professional | CG · Policy criteria applied | $102.33 | $102.33 | $102.33 |
Ambetter Setting Professional Modifier SA · Nurse practitioner Typical Low $125.89 Median $151.36 Typical High $151.36 | Professional | SA · Nurse practitioner | $125.89 | $151.36 | $151.36 |
Medica Setting Professional Modifier 25 · Same-day visit Typical Low $120.23 Median $144.54 Typical High $165.96 | Professional | 25 · Same-day visit | $120.23 | $144.54 | $165.96 |
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· 31st of 51
$115
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.