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 $51.29 Median $69.18 Typical High $81.28 | Facility | None | $51.29 | $69.18 | $81.28 |
Aetna Setting Professional Modifier None Typical Low $51.29 Median $69.18 Typical High $97.72 | Professional | None | $51.29 | $69.18 | $97.72 |
Ambetter Setting Professional Modifier None Typical Low $67.61 Median $75.86 Typical High $93.33 | Professional | None | $67.61 | $75.86 | $93.33 |
Anthem BCBS Setting Facility Modifier None Typical Low $169.82 Median $173.78 Typical High $223.87 | Facility | None | $169.82 | $173.78 | $223.87 |
Anthem BCBS Setting Professional Modifier None Typical Low $41.69 Median $77.62 Typical High $112.20 | Professional | None | $41.69 | $77.62 | $112.20 |
Cigna Setting Facility Modifier None Typical Low $151.36 Median $173.78 Typical High $199.53 | Facility | None | $151.36 | $173.78 | $199.53 |
Cigna Setting Professional Modifier None Typical Low $53.70 Median $85.11 Typical High $134.90 | Professional | None | $53.70 | $85.11 | $134.90 |
Harvard Pilgrim Setting Professional Modifier None Typical Low $44.67 Median $81.28 Typical High $177.83 | Professional | None | $44.67 | $81.28 | $177.83 |
Optum Setting Professional Modifier None Typical Low $75.86 Median $208.93 Typical High $208.93 | Professional | None | $75.86 | $208.93 | $208.93 |
United Setting Professional Modifier None Typical Low $56.23 Median $89.13 Typical High $181.97 | Professional | None | $56.23 | $89.13 | $181.97 |
Well Sense Setting Facility Modifier None Typical Low $50.12 Median $50.12 Typical High $50.12 | Facility | None | $50.12 | $50.12 | $50.12 |
Well Sense Setting Professional Modifier None Typical Low $34.67 Median $34.67 Typical High $34.67 | Professional | None | $34.67 | $34.67 | $34.67 |
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 |
|---|---|---|---|---|---|
Aetna Setting Professional Modifier 52 · Reduced service Typical Low $23.99 Median $27.54 Typical High $38.02 | Professional | 52 · Reduced service | $23.99 | $27.54 | $38.02 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $7.24 Median $8.32 Typical High $11.48 | Professional | 55 · Aftercare only | $7.24 | $8.32 | $11.48 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $4.79 Median $5.50 Typical High $7.59 | Professional | 56 · Pre-op care only | $4.79 | $5.50 | $7.59 |
Ambetter Setting Professional Modifier 25 · Same-day visit Typical Low $50.12 Median $75.86 Typical High $75.86 | Professional | 25 · Same-day visit | $50.12 | $75.86 | $75.86 |
Where New Hampshire sits
The same service costs 2.2 times more in Alaska than in New Jersey. 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· 16th of 51
$77.62
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.