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 $524.81 Median $524.81 Typical High $562.34 | Facility | None | $524.81 | $524.81 | $562.34 |
Aetna Setting Professional Modifier None Typical Low $524.81 Median $524.81 Typical High $562.34 | Professional | None | $524.81 | $524.81 | $562.34 |
Anthem BCBS Setting Professional Modifier None Typical Low $489.78 Median $562.34 Typical High $851.14 | Professional | None | $489.78 | $562.34 | $851.14 |
Cigna Setting Professional Modifier None Typical Low $354.81 Median $354.81 Typical High $630.96 | Professional | None | $354.81 | $354.81 | $630.96 |
Hometown Health Setting Professional Modifier None Typical Low $3.39 Median $416.87 Typical High $676.08 | Professional | None | $3.39 | $416.87 | $676.08 |
Hometown Health Setting Professional Modifier None Typical Low $3.39 Median $3.39 Typical High $776.25 | Professional | None | $3.39 | $3.39 | $776.25 |
Select Health Setting Facility Modifier None Typical Low $512.86 Median $512.86 Typical High $4,265.80 | Facility | None | $512.86 | $512.86 | $4,265.80 |
Select Health Setting Professional Modifier None Typical Low $309.03 Median $467.74 Typical High $645.65 | Professional | None | $309.03 | $467.74 | $645.65 |
United Setting Professional Modifier None Typical Low $346.74 Median $446.68 Typical High $660.69 | Professional | None | $346.74 | $446.68 | $660.69 |
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 $263.03 Median $263.03 Typical High $281.84 | Professional | 52 · Reduced service | $263.03 | $263.03 | $281.84 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $104.71 Median $104.71 Typical High $112.20 | Professional | 53 · Discontinued | $104.71 | $104.71 | $112.20 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $77.62 Median $77.62 Typical High $85.11 | Professional | 55 · Aftercare only | $77.62 | $77.62 | $85.11 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $52.48 Median $52.48 Typical High $56.23 | Professional | 56 · Pre-op care only | $52.48 | $52.48 | $56.23 |
Where Nevada sits
The same service costs 3.2 times more in Alaska than in New York. 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· 30th of 51
$513
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.