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 $93.33 Median $131.83 Typical High $165.96 | Facility | None | $93.33 | $131.83 | $165.96 |
Aetna Setting Professional Modifier None Typical Low $93.33 Median $123.03 Typical High $181.97 | Professional | None | $93.33 | $123.03 | $181.97 |
Ambetter Setting Professional Modifier None Typical Low $104.71 Median $128.82 Typical High $162.18 | Professional | None | $104.71 | $128.82 | $162.18 |
Anthem BCBS Setting Professional Modifier None Typical Low $75.86 Median $138.04 Typical High $229.09 | Professional | None | $75.86 | $138.04 | $229.09 |
Cigna Setting Professional Modifier None Typical Low $97.72 Median $141.25 Typical High $229.09 | Professional | None | $97.72 | $141.25 | $229.09 |
Harvard Pilgrim Setting Professional Modifier None Typical Low $81.28 Median $134.90 Typical High $257.04 | Professional | None | $81.28 | $134.90 | $257.04 |
United Setting Professional Modifier None Typical Low $89.13 Median $138.04 Typical High $257.04 | Professional | None | $89.13 | $138.04 | $257.04 |
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 $56.23 Median $56.23 Typical High $77.62 | Professional | None | $56.23 | $56.23 | $77.62 |
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 $45.71 Median $45.71 Typical High $64.57 | Professional | 52 · Reduced service | $45.71 | $45.71 | $64.57 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $13.80 Median $13.80 Typical High $19.50 | Professional | 55 · Aftercare only | $13.80 | $13.80 | $19.50 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $9.33 Median $9.33 Typical High $13.18 | Professional | 56 · Pre-op care only | $9.33 | $9.33 | $13.18 |
Ambetter Setting Professional Modifier 25 · Same-day visit Typical Low $104.71 Median $138.04 Typical High $162.18 | Professional | 25 · Same-day visit | $104.71 | $138.04 | $162.18 |
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
$138
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.