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 $24.55 Median $24.55 Typical High $24.55 | Facility | None | $24.55 | $24.55 | $24.55 |
Aetna Setting Professional Modifier None Typical Low $25.12 Median $25.12 Typical High $25.70 | Professional | None | $25.12 | $25.12 | $25.70 |
Anthem BCBS Setting Facility Modifier None Typical Low $30.90 Median $38.90 Typical High $95.50 | Facility | None | $30.90 | $38.90 | $95.50 |
Anthem BCBS Setting Professional Modifier None Typical Low $25.12 Median $25.12 Typical High $25.70 | Professional | None | $25.12 | $25.12 | $25.70 |
Cigna Setting Facility Modifier None Typical Low $38.90 Median $48.98 Typical High $66.07 | Facility | None | $38.90 | $48.98 | $66.07 |
Cigna Setting Professional Modifier None Typical Low $25.12 Median $25.12 Typical High $25.12 | Professional | None | $25.12 | $25.12 | $25.12 |
Harvard Pilgrim Setting Professional Modifier None Typical Low $16.60 Median $21.38 Typical High $34.67 | Professional | None | $16.60 | $21.38 | $34.67 |
United Setting Professional Modifier None Typical Low $16.60 Median $16.98 Typical High $26.92 | Professional | None | $16.60 | $16.98 | $26.92 |
Well Sense Setting Professional Modifier None Typical Low $25.12 Median $25.12 Typical High $25.12 | Professional | None | $25.12 | $25.12 | $25.12 |
5 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 $12.30 Median $12.30 Typical High $12.30 | Professional | 52 · Reduced service | $12.30 | $12.30 | $12.30 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $5.01 Median $5.01 Typical High $5.01 | Professional | 53 · Discontinued | $5.01 | $5.01 | $5.01 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $3.72 Median $3.72 Typical High $3.72 | Professional | 55 · Aftercare only | $3.72 | $3.72 | $3.72 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $2.45 Median $2.45 Typical High $2.45 | Professional | 56 · Pre-op care only | $2.45 | $2.45 | $2.45 |
Ambetter Setting Professional Modifier JZ · No drug discarded Typical Low $19.05 Median $19.05 Typical High $19.05 | Professional | JZ · No drug discarded | $19.05 | $19.05 | $19.05 |
Where New Hampshire sits
The same service costs 1.9 times more in Wyoming than in Arizona. 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· 32nd of 51
$25.12
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.