How much rates vary
Distribution of negotiated rates across all payers (price axis is log-scale). 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 $39.81 Median $77.62 Typical High $407.38 | Facility | None | $39.81 | $77.62 | $407.38 |
Aetna Setting Professional Modifier None Typical Low $39.81 Median $74.13 Typical High $85.11 | Professional | None | $39.81 | $74.13 | $85.11 |
Ambetter Setting Professional Modifier None Typical Low $91.20 Median $91.20 Typical High $91.20 | Professional | None | $91.20 | $91.20 | $91.20 |
Anthem BCBS Setting Facility Modifier None Typical Low $2,238.72 Median $3,548.13 Typical High $4,466.84 | Facility | None | $2,238.72 | $3,548.13 | $4,466.84 |
Anthem BCBS Setting Professional Modifier None Typical Low $40.74 Median $46.77 Typical High $77.62 | Professional | None | $40.74 | $46.77 | $77.62 |
Cigna Setting Facility Modifier None Typical Low $64.57 Median $75.86 Typical High $117.49 | Facility | None | $64.57 | $75.86 | $117.49 |
Cigna Setting Professional Modifier None Typical Low $48.98 Median $72.44 Typical High $114.82 | Professional | None | $48.98 | $72.44 | $114.82 |
Hometown Health Setting Professional Modifier None Typical Low $40.74 Median $66.07 Typical High $123.03 | Professional | None | $40.74 | $66.07 | $123.03 |
Hometown Health Setting Facility Modifier None Typical Low $69.18 Median $69.18 Typical High $69.18 | Facility | None | $69.18 | $69.18 | $69.18 |
Hometown Health Setting Professional Modifier None Typical Low $0.36 Median $54.95 Typical High $144.54 | Professional | None | $0.36 | $54.95 | $144.54 |
Select Health Setting Facility Modifier None Typical Low $37.15 Median $95.50 Typical High $4,265.80 | Facility | None | $37.15 | $95.50 | $4,265.80 |
Select Health Setting Professional Modifier None Typical Low $29.51 Median $56.23 Typical High $91.20 | Professional | None | $29.51 | $56.23 | $91.20 |
United Setting Facility Modifier None Typical Low $97.72 Median $245.47 Typical High $1,949.84 | Facility | None | $97.72 | $245.47 | $1,949.84 |
United Setting Professional Modifier None Typical Low $47.86 Median $72.44 Typical High $117.49 | Professional | None | $47.86 | $72.44 | $117.49 |
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 $19.95 Median $38.90 Typical High $41.69 | Professional | 52 · Reduced service | $19.95 | $38.90 | $41.69 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $7.94 Median $15.49 Typical High $16.98 | Professional | 53 · Discontinued | $7.94 | $15.49 | $16.98 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $6.03 Median $11.48 Typical High $12.59 | Professional | 55 · Aftercare only | $6.03 | $11.48 | $12.59 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $3.98 Median $7.76 Typical High $8.32 | Professional | 56 · Pre-op care only | $3.98 | $7.76 | $8.32 |
Where Nevada sits
The same service costs 3.8 times more in Alaska than in Virginia. 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.
Nevada· 46th of 51
$72.44
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.