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 $131.83 Median $158.49 Typical High $186.21 | Facility | None | $131.83 | $158.49 | $186.21 |
Aetna Setting Professional Modifier None Typical Low $128.82 Median $151.36 Typical High $239.88 | Professional | None | $128.82 | $151.36 | $239.88 |
Ambetter Setting Professional Modifier None Typical Low $151.36 Median $177.83 Typical High $234.42 | Professional | None | $151.36 | $177.83 | $234.42 |
Anthem BCBS Setting Facility Modifier None Typical Low $169.82 Median $173.78 Typical High $1,000.00 | Facility | None | $169.82 | $173.78 | $1,000.00 |
Anthem BCBS Setting Professional Modifier None Typical Low $117.49 Median $208.93 Typical High $263.03 | Professional | None | $117.49 | $208.93 | $263.03 |
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 $147.91 Median $199.53 Typical High $316.23 | Professional | None | $147.91 | $199.53 | $316.23 |
Harvard Pilgrim Setting Professional Modifier None Typical Low $125.89 Median $204.17 Typical High $398.11 | Professional | None | $125.89 | $204.17 | $398.11 |
Optum Setting Professional Modifier None Typical Low $173.78 Median $398.11 Typical High $407.38 | Professional | None | $173.78 | $398.11 | $407.38 |
United Setting Professional Modifier None Typical Low $134.90 Median $213.80 Typical High $398.11 | Professional | None | $134.90 | $213.80 | $398.11 |
Well Sense Setting Facility Modifier None Typical Low $109.65 Median $109.65 Typical High $109.65 | Facility | None | $109.65 | $109.65 | $109.65 |
Well Sense Setting Professional Modifier None Typical Low $87.10 Median $87.10 Typical High $87.10 | Professional | None | $87.10 | $87.10 | $87.10 |
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 $63.10 Median $66.07 Typical High $85.11 | Professional | 52 · Reduced service | $63.10 | $66.07 | $85.11 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $18.62 Median $19.95 Typical High $25.12 | Professional | 55 · Aftercare only | $18.62 | $19.95 | $25.12 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $12.59 Median $13.18 Typical High $16.98 | Professional | 56 · Pre-op care only | $12.59 | $13.18 | $16.98 |
Ambetter Setting Professional Modifier 25 · Same-day visit Typical Low $117.49 Median $177.83 Typical High $213.80 | Professional | 25 · Same-day visit | $117.49 | $177.83 | $213.80 |
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· 16th of 51
$178
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.