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 $234.42 Median $234.42 Typical High $234.42 | Facility | None | $234.42 | $234.42 | $234.42 |
Aetna Setting Professional Modifier None Typical Low $123.03 Median $162.18 Typical High $245.47 | Professional | None | $123.03 | $162.18 | $245.47 |
Ambetter Setting Professional Modifier None Typical Low $125.89 Median $158.49 Typical High $165.96 | Professional | None | $125.89 | $158.49 | $165.96 |
Anthem BCBS Setting Professional Modifier None Typical Low $100.00 Median $181.97 Typical High $281.84 | Professional | None | $100.00 | $181.97 | $281.84 |
Cigna Setting Professional Modifier None Typical Low $125.89 Median $177.83 Typical High $295.12 | Professional | None | $125.89 | $177.83 | $295.12 |
Harvard Pilgrim Setting Professional Modifier None Typical Low $109.65 Median $177.83 Typical High $331.13 | Professional | None | $109.65 | $177.83 | $331.13 |
Optum Setting Professional Modifier None Typical Low $147.91 Median $199.53 Typical High $199.53 | Professional | None | $147.91 | $199.53 | $199.53 |
United Setting Professional Modifier None Typical Low $123.03 Median $181.97 Typical High $309.03 | Professional | None | $123.03 | $181.97 | $309.03 |
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 $77.62 Median $77.62 Typical High $109.65 | Professional | None | $77.62 | $77.62 | $109.65 |
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 $61.66 Median $64.57 Typical High $87.10 | Professional | 52 · Reduced service | $61.66 | $64.57 | $87.10 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $18.62 Median $19.05 Typical High $26.30 | Professional | 55 · Aftercare only | $18.62 | $19.05 | $26.30 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $12.30 Median $12.88 Typical High $17.38 | Professional | 56 · Pre-op care only | $12.30 | $12.88 | $17.38 |
Ambetter Setting Professional Modifier 25 · Same-day visit Typical Low $158.49 Median $173.78 Typical High $204.17 | Professional | 25 · Same-day visit | $158.49 | $173.78 | $204.17 |
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· 15th of 51
$178
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.