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 $44.67 Median $2,137.96 Typical High $10,715.19 | Facility | None | $44.67 | $2,137.96 | $10,715.19 |
Aetna Setting Professional Modifier None Typical Low $44.67 Median $190.55 Typical High $275.42 | Professional | None | $44.67 | $190.55 | $275.42 |
Anthem BCBS Setting Professional Modifier None Typical Low $42.66 Median $147.91 Typical High $363.08 | Professional | None | $42.66 | $147.91 | $363.08 |
Cigna Setting Professional Modifier None Typical Low $36.31 Median $162.18 Typical High $363.08 | Professional | None | $36.31 | $162.18 | $363.08 |
Hometown Health Setting Professional Modifier None Typical Low $35.48 Median $74.13 Typical High $309.03 | Professional | None | $35.48 | $74.13 | $309.03 |
Hometown Health Setting Professional Modifier None Typical Low $0.18 Median $54.95 Typical High $309.03 | Professional | None | $0.18 | $54.95 | $309.03 |
Select Health Setting Facility Modifier None Typical Low $37.15 Median $208.93 Typical High $4,265.80 | Facility | None | $37.15 | $208.93 | $4,265.80 |
Select Health Setting Professional Modifier None Typical Low $28.18 Median $28.18 Typical High $37.15 | Professional | None | $28.18 | $28.18 | $37.15 |
United Setting Facility Modifier None Typical Low $251.19 Median $1,412.54 Typical High $2,041.74 | Facility | None | $251.19 | $1,412.54 | $2,041.74 |
United Setting Professional Modifier None Typical Low $31.62 Median $190.55 Typical High $316.23 | Professional | None | $31.62 | $190.55 | $316.23 |
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 $22.39 Median $50.12 Typical High $138.04 | Professional | 52 · Reduced service | $22.39 | $50.12 | $138.04 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $8.91 Median $19.95 Typical High $54.95 | Professional | 53 · Discontinued | $8.91 | $19.95 | $54.95 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $6.76 Median $15.14 Typical High $41.69 | Professional | 55 · Aftercare only | $6.76 | $15.14 | $41.69 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $4.47 Median $10.00 Typical High $27.54 | Professional | 56 · Pre-op care only | $4.47 | $10.00 | $27.54 |
Ambetter Setting Professional Modifier 59 · Distinct service Typical Low $37.15 Median $37.15 Typical High $37.15 | Professional | 59 · Distinct service | $37.15 | $37.15 | $37.15 |
Where Nevada sits
The same service costs 5.2 times more in North Carolina than in Hawaii. 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· 35th of 51
$162
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.