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 $14.79 Median $16.22 Typical High $85.11 | Facility | None | $14.79 | $16.22 | $85.11 |
Aetna Setting Professional Modifier None Typical Low $14.79 Median $38.02 Typical High $85.11 | Professional | None | $14.79 | $38.02 | $85.11 |
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 $15.14 Median $17.78 Typical High $28.84 | Professional | None | $15.14 | $17.78 | $28.84 |
Cigna Setting Facility Modifier None Typical Low $63.10 Median $75.86 Typical High $912.01 | Facility | None | $63.10 | $75.86 | $912.01 |
Cigna Setting Professional Modifier None Typical Low $12.59 Median $58.88 Typical High $100.00 | Professional | None | $12.59 | $58.88 | $100.00 |
Hometown Health Setting Professional Modifier None Typical Low $10.00 Median $50.12 Typical High $100.00 | Professional | None | $10.00 | $50.12 | $100.00 |
Hometown Health Setting Facility Modifier None Typical Low $66.07 Median $66.07 Typical High $66.07 | Facility | None | $66.07 | $66.07 | $66.07 |
Hometown Health Setting Professional Modifier None Typical Low $0.60 Median $19.95 Typical High $112.20 | Professional | None | $0.60 | $19.95 | $112.20 |
Select Health Setting Facility Modifier None Typical Low $13.18 Median $74.13 Typical High $4,265.80 | Facility | None | $13.18 | $74.13 | $4,265.80 |
Select Health Setting Professional Modifier None Typical Low $10.72 Median $19.95 Typical High $70.79 | Professional | None | $10.72 | $19.95 | $70.79 |
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 $15.49 Median $64.57 Typical High $109.65 | Professional | None | $15.49 | $64.57 | $109.65 |
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 $7.41 Median $10.96 Typical High $38.90 | Professional | 52 · Reduced service | $7.41 | $10.96 | $38.90 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $2.95 Median $4.37 Typical High $15.49 | Professional | 53 · Discontinued | $2.95 | $4.37 | $15.49 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $2.19 Median $3.24 Typical High $11.75 | Professional | 55 · Aftercare only | $2.19 | $3.24 | $11.75 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $1.48 Median $2.19 Typical High $7.76 | Professional | 56 · Pre-op care only | $1.48 | $2.19 | $7.76 |
Where Nevada sits
The same service costs 5.9 times more in Iowa than in Kentucky. 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· 34th of 51
$58.88
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.