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 Professional Modifier None Typical Low $186.21 Median $234.42 Typical High $275.42 | Professional | None | $186.21 | $234.42 | $275.42 |
Anthem BCBS Setting Professional Modifier None Typical Low $177.83 Median $275.42 Typical High $309.03 | Professional | None | $177.83 | $275.42 | $309.03 |
Cigna Setting Professional Modifier None Typical Low $204.17 Median $251.19 Typical High $426.58 | Professional | None | $204.17 | $251.19 | $426.58 |
Harvard Pilgrim Setting Professional Modifier None Typical Low $194.98 Median $263.03 Typical High $467.74 | Professional | None | $194.98 | $263.03 | $467.74 |
Optum Setting Professional Modifier None Typical Low $151.36 Median $251.19 Typical High $251.19 | Professional | None | $151.36 | $251.19 | $251.19 |
United Setting Professional Modifier None Typical Low $199.53 Median $257.04 Typical High $457.09 | Professional | None | $199.53 | $257.04 | $457.09 |
Well Sense Setting Professional Modifier None Typical Low $131.83 Median $131.83 Typical High $177.83 | Professional | None | $131.83 | $131.83 | $177.83 |
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 $93.33 Median $114.82 Typical High $134.90 | Professional | 52 · Reduced service | $93.33 | $114.82 | $134.90 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $28.18 Median $33.88 Typical High $39.81 | Professional | 55 · Aftercare only | $28.18 | $33.88 | $39.81 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $18.62 Median $22.91 Typical High $26.92 | Professional | 56 · Pre-op care only | $18.62 | $22.91 | $26.92 |
Ambetter Setting Professional Modifier 25 · Same-day visit Typical Low $213.80 Median $213.80 Typical High $213.80 | Professional | 25 · Same-day visit | $213.80 | $213.80 | $213.80 |
Well Sense Setting Facility Modifier HN · Bachelor's level Typical Low $134.90 Median $134.90 Typical High $134.90 | Facility | HN · Bachelor's level | $134.90 | $134.90 | $134.90 |
Where New Hampshire sits
The same service costs 2.4 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· 11th of 51
$251
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.