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 $104.71 Median $1,698.24 Typical High $4,365.16 | Facility | None | $104.71 | $1,698.24 | $4,365.16 |
Aetna Setting Professional Modifier None Typical Low $95.50 Median $125.89 Typical High $141.25 | Professional | None | $95.50 | $125.89 | $141.25 |
Ambetter Setting Professional Modifier None Typical Low $141.25 Median $141.25 Typical High $141.25 | Professional | None | $141.25 | $141.25 | $141.25 |
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 $97.72 Median $112.20 Typical High $177.83 | Professional | None | $97.72 | $112.20 | $177.83 |
Cigna Setting Facility Modifier None Typical Low $93.33 Median $109.65 Typical High $169.82 | Facility | None | $93.33 | $109.65 | $169.82 |
Cigna Setting Professional Modifier None Typical Low $85.11 Median $114.82 Typical High $186.21 | Professional | None | $85.11 | $114.82 | $186.21 |
Hometown Health Setting Professional Modifier None Typical Low $69.18 Median $112.20 Typical High $186.21 | Professional | None | $69.18 | $112.20 | $186.21 |
Hometown Health Setting Facility Modifier None Typical Low $100.00 Median $100.00 Typical High $100.00 | Facility | None | $100.00 | $100.00 | $100.00 |
Hometown Health Setting Professional Modifier None Typical Low $0.66 Median $134.90 Typical High $223.87 | Professional | None | $0.66 | $134.90 | $223.87 |
Select Health Setting Facility Modifier None Typical Low $89.13 Median $147.91 Typical High $4,265.80 | Facility | None | $89.13 | $147.91 | $4,265.80 |
Select Health Setting Professional Modifier None Typical Low $72.44 Median $117.49 Typical High $147.91 | Professional | None | $72.44 | $117.49 | $147.91 |
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 $91.20 Median $123.03 Typical High $190.55 | Professional | None | $91.20 | $123.03 | $190.55 |
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 $47.86 Median $63.10 Typical High $69.18 | Professional | 52 · Reduced service | $47.86 | $63.10 | $69.18 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $19.05 Median $25.12 Typical High $28.18 | Professional | 53 · Discontinued | $19.05 | $25.12 | $28.18 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $14.13 Median $19.05 Typical High $20.89 | Professional | 55 · Aftercare only | $14.13 | $19.05 | $20.89 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $9.55 Median $12.59 Typical High $13.80 | Professional | 56 · Pre-op care only | $9.55 | $12.59 | $13.80 |
Where Nevada sits
The same service costs 3.7 times more in Alaska than in Florida. 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· 45th of 51
$120
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.