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 $199.53 Median $199.53 Typical High $199.53 | Facility | None | $199.53 | $199.53 | $199.53 |
Aetna Setting Professional Modifier None Typical Low $102.33 Median $138.04 Typical High $208.93 | Professional | None | $102.33 | $138.04 | $208.93 |
Ambetter Setting Professional Modifier None Typical Low $138.04 Median $138.04 Typical High $177.83 | Professional | None | $138.04 | $138.04 | $177.83 |
Anthem BCBS Setting Professional Modifier None Typical Low $87.10 Median $147.91 Typical High $245.47 | Professional | None | $87.10 | $147.91 | $245.47 |
Cigna Setting Professional Modifier None Typical Low $104.71 Median $154.88 Typical High $251.19 | Professional | None | $104.71 | $154.88 | $251.19 |
Harvard Pilgrim Setting Professional Modifier None Typical Low $89.13 Median $151.36 Typical High $288.40 | Professional | None | $89.13 | $151.36 | $288.40 |
Optum Setting Professional Modifier None Typical Low $128.82 Median $173.78 Typical High $173.78 | Professional | None | $128.82 | $173.78 | $173.78 |
United Setting Professional Modifier None Typical Low $102.33 Median $154.88 Typical High $269.15 | Professional | None | $102.33 | $154.88 | $269.15 |
Well Sense Setting Facility Modifier None Typical Low $64.57 Median $64.57 Typical High $77.62 | Facility | None | $64.57 | $64.57 | $77.62 |
Well Sense Setting Professional Modifier None Typical Low $63.10 Median $63.10 Typical High $93.33 | Professional | None | $63.10 | $63.10 | $93.33 |
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 $50.12 Median $52.48 Typical High $74.13 | Professional | 52 · Reduced service | $50.12 | $52.48 | $74.13 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $15.14 Median $15.49 Typical High $22.39 | Professional | 55 · Aftercare only | $15.14 | $15.49 | $22.39 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $10.00 Median $10.47 Typical High $14.79 | Professional | 56 · Pre-op care only | $10.00 | $10.47 | $14.79 |
Ambetter Setting Professional Modifier 25 · Same-day visit Typical Low $151.36 Median $151.36 Typical High $177.83 | Professional | 25 · Same-day visit | $151.36 | $151.36 | $177.83 |
Where New Hampshire sits
The same service costs 2.7 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
$148
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.