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 $31.62 Median $33.11 Typical High $52.48 | Facility | None | $31.62 | $33.11 | $52.48 |
Aetna Setting Professional Modifier None Typical Low $26.30 Median $38.90 Typical High $60.26 | Professional | None | $26.30 | $38.90 | $60.26 |
Ambetter Setting Professional Modifier None Typical Low $34.67 Median $34.67 Typical High $40.74 | Professional | None | $34.67 | $34.67 | $40.74 |
Anthem BCBS Setting Professional Modifier None Typical Low $20.89 Median $39.81 Typical High $74.13 | Professional | None | $20.89 | $39.81 | $74.13 |
Cigna Setting Professional Modifier None Typical Low $26.92 Median $45.71 Typical High $72.44 | Professional | None | $26.92 | $45.71 | $72.44 |
Harvard Pilgrim Setting Professional Modifier None Typical Low $22.39 Median $43.65 Typical High $83.18 | Professional | None | $22.39 | $43.65 | $83.18 |
United Setting Professional Modifier None Typical Low $26.30 Median $44.67 Typical High $81.28 | Professional | None | $26.30 | $44.67 | $81.28 |
Well Sense Setting Professional Modifier None Typical Low $18.20 Median $18.20 Typical High $27.54 | Professional | None | $18.20 | $18.20 | $27.54 |
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 $12.59 Median $16.22 Typical High $24.55 | Professional | 52 · Reduced service | $12.59 | $16.22 | $24.55 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $3.80 Median $4.90 Typical High $7.41 | Professional | 55 · Aftercare only | $3.80 | $4.90 | $7.41 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $2.51 Median $3.31 Typical High $4.90 | Professional | 56 · Pre-op care only | $2.51 | $3.31 | $4.90 |
Well Sense Setting Facility Modifier EP · Child screening program Typical Low $26.92 Median $26.92 Typical High $32.36 | Facility | EP · Child screening program | $26.92 | $26.92 | $32.36 |
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· 12th of 51
$42.66
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.