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 $5.62 Median $5.62 Typical High $5.62 | Facility | None | $5.62 | $5.62 | $5.62 |
Aetna Setting Professional Modifier None Typical Low $5.37 Median $5.62 Typical High $5.62 | Professional | None | $5.37 | $5.62 | $5.62 |
Ambetter Setting Professional Modifier None Typical Low $3.89 Median $5.13 Typical High $7.24 | Professional | None | $3.89 | $5.13 | $7.24 |
Anthem BCBS Setting Professional Modifier None Typical Low $5.01 Median $6.31 Typical High $7.08 | Professional | None | $5.01 | $6.31 | $7.08 |
Anthem BCBS Setting Professional Modifier HO · Master's level Typical Low $4.68 Median $4.68 Typical High $4.68 | Professional | HO · Master's level | $4.68 | $4.68 | $4.68 |
Cigna Setting Professional Modifier None Typical Low $3.98 Median $3.98 Typical High $6.03 | Professional | None | $3.98 | $3.98 | $6.03 |
Harvard Pilgrim Setting Professional Modifier None Typical Low $4.07 Median $4.07 Typical High $8.51 | Professional | None | $4.07 | $4.07 | $8.51 |
Optum Setting Professional Modifier None Typical Low $6.76 Median $6.76 Typical High $6.76 | Professional | None | $6.76 | $6.76 | $6.76 |
United Setting Professional Modifier None Typical Low $6.03 Median $8.91 Typical High $17.38 | Professional | None | $6.03 | $8.91 | $17.38 |
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 Professional Modifier 52 · Reduced service Typical Low $2.69 Median $2.82 Typical High $2.82 | Professional | 52 · Reduced service | $2.69 | $2.82 | $2.82 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $1.07 Median $1.12 Typical High $1.12 | Professional | 53 · Discontinued | $1.07 | $1.12 | $1.12 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $0.81 Median $0.85 Typical High $0.85 | Professional | 55 · Aftercare only | $0.81 | $0.85 | $0.85 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $0.54 Median $0.56 Typical High $0.56 | Professional | 56 · Pre-op care only | $0.54 | $0.56 | $0.56 |
Well Sense Setting Facility Modifier U1 · State-defined + U2 · State-defined Typical Low $8.71 Median $10.23 Typical High $10.23 | Facility | U1 · State-defined + U2 · State-defined | $8.71 | $10.23 | $10.23 |
Where New Hampshire sits
The same service costs 2.7 times more in North Dakota than in New Mexico. 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.
New Hampshire· 22nd of 51
$5.50
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.