How much rates vary
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 $186.21 Median $186.21 Typical High $186.21 | Facility | None | $186.21 | $186.21 | $186.21 |
Aetna Setting Professional Modifier None Typical Low $89.13 Median $123.03 Typical High $186.21 | Professional | None | $89.13 | $123.03 | $186.21 |
Ambetter Setting Professional Modifier None Typical Low $138.04 Median $138.04 Typical High $138.04 | Professional | None | $138.04 | $138.04 | $138.04 |
Anthem BCBS Setting Professional Modifier None Typical Low $72.44 Median $131.83 Typical High $223.87 | Professional | None | $72.44 | $131.83 | $223.87 |
Cigna Setting Professional Modifier None Typical Low $93.33 Median $141.25 Typical High $223.87 | Professional | None | $93.33 | $141.25 | $223.87 |
Harvard Pilgrim Setting Professional Modifier None Typical Low $79.43 Median $134.90 Typical High $263.03 | Professional | None | $79.43 | $134.90 | $263.03 |
Optum Setting Professional Modifier None Typical Low $117.49 Median $158.49 Typical High $158.49 | Professional | None | $117.49 | $158.49 | $158.49 |
United Setting Professional Modifier None Typical Low $91.20 Median $141.25 Typical High $245.47 | Professional | None | $91.20 | $141.25 | $245.47 |
Well Sense Setting Facility Modifier None Typical Low $70.79 Median $70.79 Typical High $85.11 | Facility | None | $70.79 | $70.79 | $85.11 |
Well Sense Setting Professional Modifier None Typical Low $56.23 Median $56.23 Typical High $87.10 | Professional | None | $56.23 | $56.23 | $87.10 |
3 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 $44.67 Median $48.98 Typical High $69.18 | Professional | 52 · Reduced service | $44.67 | $48.98 | $69.18 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $13.49 Median $14.79 Typical High $20.42 | Professional | 55 · Aftercare only | $13.49 | $14.79 | $20.42 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $8.91 Median $9.77 Typical High $13.80 | Professional | 56 · Pre-op care only | $8.91 | $9.77 | $13.80 |
Where New Hampshire sits
The same service costs 2.8 times more in Alaska than in Washington, DC. 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· 14th of 51
$135
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.