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 $162.18 Median $162.18 Typical High $162.18 | Facility | None | $162.18 | $162.18 | $162.18 |
Aetna Setting Professional Modifier None Typical Low $89.13 Median $117.49 Typical High $177.83 | Professional | None | $89.13 | $117.49 | $177.83 |
Ambetter Setting Professional Modifier None Typical Low $102.33 Median $102.33 Typical High $141.25 | Professional | None | $102.33 | $102.33 | $141.25 |
Anthem BCBS Setting Professional Modifier None Typical Low $72.44 Median $134.90 Typical High $223.87 | Professional | None | $72.44 | $134.90 | $223.87 |
Cigna Setting Professional Modifier None Typical Low $95.50 Median $138.04 Typical High $223.87 | Professional | None | $95.50 | $138.04 | $223.87 |
Harvard Pilgrim Setting Professional Modifier None Typical Low $79.43 Median $131.83 Typical High $257.04 | Professional | None | $79.43 | $131.83 | $257.04 |
United Setting Professional Modifier None Typical Low $89.13 Median $134.90 Typical High $251.19 | Professional | None | $89.13 | $134.90 | $251.19 |
Well Sense Setting Facility Modifier None Typical Low $97.72 Median $97.72 Typical High $117.49 | Facility | None | $97.72 | $97.72 | $117.49 |
Well Sense Setting Professional Modifier None Typical Low $56.23 Median $56.23 Typical High $75.86 | Professional | None | $56.23 | $56.23 | $75.86 |
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 $44.67 Median $46.77 Typical High $64.57 | Professional | 52 · Reduced service | $44.67 | $46.77 | $64.57 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $13.49 Median $14.13 Typical High $19.50 | Professional | 55 · Aftercare only | $13.49 | $14.13 | $19.50 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $8.91 Median $9.33 Typical High $12.88 | Professional | 56 · Pre-op care only | $8.91 | $9.33 | $12.88 |
Ambetter Setting Professional Modifier 25 · Same-day visit Typical Low $102.33 Median $144.54 Typical High $158.49 | Professional | 25 · Same-day visit | $102.33 | $144.54 | $158.49 |
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· 13th 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.