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 $26.30 Median $41.69 Typical High $58.88 | Facility | None | $26.30 | $41.69 | $58.88 |
Aetna Setting Professional Modifier None Typical Low $26.30 Median $41.69 Typical High $63.10 | Professional | None | $26.30 | $41.69 | $63.10 |
Ambetter Setting Professional Modifier None Typical Low $51.29 Median $60.26 Typical High $79.43 | Professional | None | $51.29 | $60.26 | $79.43 |
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 $31.62 Median $60.26 Typical High $75.86 | Professional | None | $31.62 | $60.26 | $75.86 |
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 $38.90 Median $58.88 Typical High $100.00 | Professional | None | $38.90 | $58.88 | $100.00 |
Harvard Pilgrim Setting Professional Modifier None Typical Low $33.88 Median $61.66 Typical High $112.20 | Professional | None | $33.88 | $61.66 | $112.20 |
Optum Setting Professional Modifier None Typical Low $57.54 Median $89.13 Typical High $95.50 | Professional | None | $57.54 | $89.13 | $95.50 |
United Setting Professional Modifier None Typical Low $28.18 Median $53.70 Typical High $91.20 | Professional | None | $28.18 | $53.70 | $91.20 |
Well Sense Setting Facility Modifier None Typical Low $36.31 Median $36.31 Typical High $36.31 | Facility | None | $36.31 | $36.31 | $36.31 |
Well Sense Setting Professional Modifier None Typical Low $18.20 Median $18.20 Typical High $18.20 | Professional | None | $18.20 | $18.20 | $18.20 |
6 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 $13.18 Median $16.60 Typical High $22.39 | Professional | 52 · Reduced service | $13.18 | $16.60 | $22.39 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $3.98 Median $5.01 Typical High $6.76 | Professional | 55 · Aftercare only | $3.98 | $5.01 | $6.76 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $2.63 Median $3.39 Typical High $4.47 | Professional | 56 · Pre-op care only | $2.63 | $3.39 | $4.47 |
Ambetter Setting Professional Modifier 25 · Same-day visit Typical Low $30.20 Median $30.20 Typical High $58.88 | Professional | 25 · Same-day visit | $30.20 | $30.20 | $58.88 |
Ambetter Setting Professional Modifier GF · Non-physician, rural hospital Typical Low $34.67 Median $34.67 Typical High $34.67 | Professional | GF · Non-physician, rural hospital | $34.67 | $34.67 | $34.67 |
Ambetter Setting Professional Modifier HF · Substance use program Typical Low $51.29 Median $51.29 Typical High $87.10 | Professional | HF · Substance use program | $51.29 | $51.29 | $87.10 |
Where New Hampshire sits
The same service costs 2.4 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
$48.98
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.