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 $22.39 Median $35.48 Typical High $36.31 | Facility | None | $22.39 | $35.48 | $36.31 |
Aetna Setting Professional Modifier None Typical Low $22.39 Median $35.48 Typical High $67.61 | Professional | None | $22.39 | $35.48 | $67.61 |
Ambetter Setting Professional Modifier None Typical Low $31.62 Median $40.74 Typical High $75.86 | Professional | None | $31.62 | $40.74 | $75.86 |
Anthem BCBS Setting Professional Modifier None Typical Low $21.88 Median $36.31 Typical High $54.95 | Professional | None | $21.88 | $36.31 | $54.95 |
CareSource Setting Professional Modifier None Typical Low $34.67 Median $44.67 Typical High $54.95 | Professional | None | $34.67 | $44.67 | $54.95 |
Cigna Setting Professional Modifier None Typical Low $25.12 Median $38.90 Typical High $87.10 | Professional | None | $25.12 | $38.90 | $87.10 |
Kaiser Permanente Setting Professional Modifier None Typical Low $20.89 Median $40.74 Typical High $61.66 | Professional | None | $20.89 | $40.74 | $61.66 |
Oscar Health Setting Professional Modifier None Typical Low $34.67 Median $46.77 Typical High $79.43 | Professional | None | $34.67 | $46.77 | $79.43 |
United Setting Professional Modifier None Typical Low $24.55 Median $40.74 Typical High $74.13 | Professional | None | $24.55 | $40.74 | $74.13 |
6 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 $10.96 Median $15.49 Typical High $19.05 | Professional | 52 · Reduced service | $10.96 | $15.49 | $19.05 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $3.31 Median $4.68 Typical High $5.62 | Professional | 55 · Aftercare only | $3.31 | $4.68 | $5.62 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $2.24 Median $3.09 Typical High $3.80 | Professional | 56 · Pre-op care only | $2.24 | $3.09 | $3.80 |
Ambetter Setting Professional Modifier 25 · Same-day visit Typical Low $34.67 Median $40.74 Typical High $77.62 | Professional | 25 · Same-day visit | $34.67 | $40.74 | $77.62 |
Ambetter Setting Professional Modifier 33 · Preventive service Typical Low $31.62 Median $37.15 Typical High $50.12 | Professional | 33 · Preventive service | $31.62 | $37.15 | $50.12 |
Anthem BCBS Setting Professional Modifier EP · Child screening program Typical Low $28.18 Median $28.18 Typical High $28.18 | Professional | EP · Child screening program | $28.18 | $28.18 | $28.18 |
Where Georgia sits
The same service costs 2.8 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· 20th of 51
$37.15
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.