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 $19.05 Median $23.44 Typical High $28.84 | Facility | None | $19.05 | $23.44 | $28.84 |
Aetna Setting Professional Modifier None Typical Low $19.05 Median $23.44 Typical High $28.84 | Professional | None | $19.05 | $23.44 | $28.84 |
Ambetter Setting Professional Modifier None Typical Low $26.30 Median $32.36 Typical High $39.81 | Professional | None | $26.30 | $32.36 | $39.81 |
Anthem BCBS Setting Professional Modifier None Typical Low $19.50 Median $24.55 Typical High $29.51 | Professional | None | $19.50 | $24.55 | $29.51 |
CareSource Setting Facility Modifier None Typical Low $22.39 Median $28.18 Typical High $38.90 | Facility | None | $22.39 | $28.18 | $38.90 |
CareSource Setting Professional Modifier None Typical Low $28.84 Median $30.90 Typical High $38.90 | Professional | None | $28.84 | $30.90 | $38.90 |
Cigna Setting Facility Modifier None Typical Low $37.15 Median $37.15 Typical High $37.15 | Facility | None | $37.15 | $37.15 | $37.15 |
Cigna Setting Professional Modifier None Typical Low $28.18 Median $29.51 Typical High $154.88 | Professional | None | $28.18 | $29.51 | $154.88 |
Molina Setting Professional Modifier None Typical Low $25.70 Median $26.30 Typical High $27.54 | Professional | None | $25.70 | $26.30 | $27.54 |
United Setting Professional Modifier None Typical Low $27.54 Median $33.88 Typical High $41.69 | Professional | None | $27.54 | $33.88 | $41.69 |
5 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 Facility Modifier 52 · Reduced service Typical Low $12.02 Median $12.59 Typical High $15.85 | Facility | 52 · Reduced service | $12.02 | $12.59 | $15.85 |
Aetna Setting Professional Modifier 52 · Reduced service Typical Low $12.02 Median $13.18 Typical High $14.45 | Professional | 52 · Reduced service | $12.02 | $13.18 | $14.45 |
Ambetter Setting Professional Modifier 25 · Same-day visit Typical Low $32.36 Median $32.36 Typical High $32.36 | Professional | 25 · Same-day visit | $32.36 | $32.36 | $32.36 |
Ambetter Setting Professional Modifier GC · Resident with teaching physician Typical Low $32.36 Median $32.36 Typical High $38.90 | Professional | GC · Resident with teaching physician | $32.36 | $32.36 | $38.90 |
Ambetter Setting Professional Modifier SA · Nurse practitioner Typical Low $26.30 Median $26.30 Typical High $26.30 | Professional | SA · Nurse practitioner | $26.30 | $26.30 | $26.30 |
Where Kentucky sits
The same service costs 2.5 times more in Alaska than in New York. 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.
Kentucky· 49th of 51
$26.30
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.