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 $79.43 Median $104.71 Typical High $131.83 | Facility | None | $79.43 | $104.71 | $131.83 |
Aetna Setting Professional Modifier None Typical Low $79.43 Median $97.72 Typical High $144.54 | Professional | None | $79.43 | $97.72 | $144.54 |
Ambetter Setting Professional Modifier None Typical Low $93.33 Median $120.23 Typical High $154.88 | Professional | None | $93.33 | $120.23 | $154.88 |
Anthem BCBS Setting Facility Modifier None Typical Low $169.82 Median $173.78 Typical High $602.56 | Facility | None | $169.82 | $173.78 | $602.56 |
Anthem BCBS Setting Professional Modifier None Typical Low $72.44 Median $125.89 Typical High $173.78 | Professional | None | $72.44 | $125.89 | $173.78 |
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 $91.20 Median $128.82 Typical High $208.93 | Professional | None | $91.20 | $128.82 | $208.93 |
Harvard Pilgrim Setting Professional Modifier None Typical Low $77.62 Median $128.82 Typical High $263.03 | Professional | None | $77.62 | $128.82 | $263.03 |
Optum Setting Professional Modifier None Typical Low $117.49 Median $245.47 Typical High $269.15 | Professional | None | $117.49 | $245.47 | $269.15 |
United Setting Professional Modifier None Typical Low $83.18 Median $131.83 Typical High $263.03 | Professional | None | $83.18 | $131.83 | $263.03 |
Well Sense Setting Facility Modifier None Typical Low $72.44 Median $72.44 Typical High $72.44 | Facility | None | $72.44 | $72.44 | $72.44 |
Well Sense Setting Professional Modifier None Typical Low $53.70 Median $53.70 Typical High $53.70 | Professional | None | $53.70 | $53.70 | $53.70 |
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 $38.02 Median $41.69 Typical High $54.95 | Professional | 52 · Reduced service | $38.02 | $41.69 | $54.95 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $11.48 Median $12.30 Typical High $16.60 | Professional | 55 · Aftercare only | $11.48 | $12.30 | $16.60 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $7.76 Median $8.32 Typical High $10.96 | Professional | 56 · Pre-op care only | $7.76 | $8.32 | $10.96 |
Ambetter Setting Professional Modifier 25 · Same-day visit Typical Low $75.86 Median $120.23 Typical High $154.88 | Professional | 25 · Same-day visit | $75.86 | $120.23 | $154.88 |
Where New Hampshire sits
The same service costs 2.3 times more in Alaska than in Alabama. 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· 15th of 51
$120
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.