How much rates vary
Facilitymedian $2,089 · 10th to 90th $759 to $4,786Professionalmedian $89 · 10th to 90th $59 to $166
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 $588.84 Median $794.33 Typical High $891.25 | Facility | None | $588.84 | $794.33 | $891.25 |
Aetna Setting Professional Modifier None Typical Low $51.29 Median $64.57 Typical High $107.15 | Professional | None | $51.29 | $64.57 | $107.15 |
AllWays Health Partners Setting Facility Modifier None Typical Low $338.84 Median $338.84 Typical High $338.84 | Facility | None | $338.84 | $338.84 | $338.84 |
Ambetter Setting Professional Modifier None Typical Low $64.57 Median $75.86 Typical High $218.78 | Professional | None | $64.57 | $75.86 | $218.78 |
Anthem BCBS Setting Facility Modifier None Typical Low $1,047.13 Median $2,570.40 Typical High $4,786.30 | Facility | None | $1,047.13 | $2,570.40 | $4,786.30 |
Anthem BCBS Setting Professional Modifier None Typical Low $74.13 Median $91.20 Typical High $138.04 | Professional | None | $74.13 | $91.20 | $138.04 |
BCBS Vermont Setting Facility Modifier None Typical Low $758.58 Median $758.58 Typical High $933.25 | Facility | None | $758.58 | $758.58 | $933.25 |
Cigna Setting Facility Modifier None Typical Low $1,584.89 Median $2,454.71 Typical High $4,265.80 | Facility | None | $1,584.89 | $2,454.71 | $4,265.80 |
Cigna Setting Professional Modifier None Typical Low $74.13 Median $93.33 Typical High $165.96 | Professional | None | $74.13 | $93.33 | $165.96 |
Community Health Options Setting Facility Modifier None Typical Low $1,548.82 Median $1,548.82 Typical High $2,089.30 | Facility | None | $1,548.82 | $1,548.82 | $2,089.30 |
Harvard Pilgrim Setting Professional Modifier None Typical Low $75.86 Median $117.49 Typical High $194.98 | Professional | None | $75.86 | $117.49 | $194.98 |
Martin's Point Setting Facility Modifier None Typical Low $588.84 Median $794.33 Typical High $891.25 | Facility | None | $588.84 | $794.33 | $891.25 |
Mass General Brigham Setting Facility Modifier None Typical Low $338.84 Median $338.84 Typical High $338.84 | Facility | None | $338.84 | $338.84 | $338.84 |
Optum Setting Professional Modifier None Typical Low $67.61 Median $79.43 Typical High $208.93 | Professional | None | $67.61 | $79.43 | $208.93 |
United Setting Facility Modifier None Typical Low $1,621.81 Median $1,621.81 Typical High $1,659.59 | Facility | None | $1,621.81 | $1,621.81 | $1,659.59 |
United Setting Professional Modifier None Typical Low $67.61 Median $104.71 Typical High $190.55 | Professional | None | $67.61 | $104.71 | $190.55 |
Well Sense Setting Professional Modifier None Typical Low $45.71 Median $45.71 Typical High $45.71 | Professional | None | $45.71 | $45.71 | $45.71 |
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 $28.84 Median $32.36 Typical High $32.36 | Professional | 52 · Reduced service | $28.84 | $32.36 | $32.36 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $8.51 Median $9.55 Typical High $9.55 | Professional | 55 · Aftercare only | $8.51 | $9.55 | $9.55 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $5.75 Median $6.46 Typical High $6.46 | Professional | 56 · Pre-op care only | $5.75 | $6.46 | $6.46 |
Ambetter Setting Professional Modifier 25 · Same-day visit Typical Low $67.61 Median $89.13 Typical High $162.18 | Professional | 25 · Same-day visit | $67.61 | $89.13 | $162.18 |
Fallon Health Setting Facility Modifier TD · Registered nurse Typical Low $64.57 Median $64.57 Typical High $64.57 | Facility | TD · Registered nurse | $64.57 | $64.57 | $64.57 |
Where New Hampshire sits
The same service costs 11.2 times more in California than in Idaho. 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.
Physician feeFacility fee
CA $2,527ID $226
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.