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 $2.14 Median $2.14 Typical High $3.63 | Facility | None | $2.14 | $2.14 | $3.63 |
Aetna Setting Professional Modifier None Typical Low $2.14 Median $2.14 Typical High $2.24 | Professional | None | $2.14 | $2.14 | $2.24 |
Ambetter Setting Professional Modifier None Typical Low $2.51 Median $2.51 Typical High $2.51 | Professional | None | $2.51 | $2.51 | $2.51 |
Anthem BCBS Setting Facility Modifier None Typical Low $2.69 Median $3.39 Typical High $8.13 | Facility | None | $2.69 | $3.39 | $8.13 |
Anthem BCBS Setting Professional Modifier None Typical Low $2.14 Median $2.14 Typical High $2.19 | Professional | None | $2.14 | $2.14 | $2.19 |
Cigna Setting Facility Modifier None Typical Low $3.31 Median $4.17 Typical High $5.62 | Facility | None | $3.31 | $4.17 | $5.62 |
Cigna Setting Professional Modifier None Typical Low $2.14 Median $2.14 Typical High $2.14 | Professional | None | $2.14 | $2.14 | $2.14 |
Harvard Pilgrim Setting Professional Modifier None Typical Low $2.14 Median $2.19 Typical High $3.16 | Professional | None | $2.14 | $2.19 | $3.16 |
United Setting Professional Modifier None Typical Low $2.09 Median $2.19 Typical High $2.29 | Professional | None | $2.09 | $2.19 | $2.29 |
Well Sense Setting Professional Modifier None Typical Low $2.14 Median $2.14 Typical High $2.14 | Professional | None | $2.14 | $2.14 | $2.14 |
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 $1.07 Median $1.07 Typical High $1.07 | Professional | 52 · Reduced service | $1.07 | $1.07 | $1.07 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $0.43 Median $0.43 Typical High $0.43 | Professional | 53 · Discontinued | $0.43 | $0.43 | $0.43 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $0.32 Median $0.32 Typical High $0.32 | Professional | 55 · Aftercare only | $0.32 | $0.32 | $0.32 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $0.21 Median $0.21 Typical High $0.21 | Professional | 56 · Pre-op care only | $0.21 | $0.21 | $0.21 |
Where New Hampshire sits
The same service costs 1.9 times more in Wyoming than in Pennsylvania. 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· 35th of 51
$2.14
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.