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 $302.00 Median $302.00 Typical High $331.13 | Facility | None | $302.00 | $302.00 | $331.13 |
Aetna Setting Professional Modifier None Typical Low $281.84 Median $302.00 Typical High $331.13 | Professional | None | $281.84 | $302.00 | $331.13 |
Ambetter Setting Professional Modifier None Typical Low $288.40 Median $288.40 Typical High $288.40 | Professional | None | $288.40 | $288.40 | $288.40 |
Anthem BCBS Setting Professional Modifier None Typical Low $288.40 Median $331.13 Typical High $501.19 | Professional | None | $288.40 | $331.13 | $501.19 |
Cigna Setting Professional Modifier None Typical Low $190.55 Median $190.55 Typical High $346.74 | Professional | None | $190.55 | $190.55 | $346.74 |
Hometown Health Setting Professional Modifier None Typical Low $1.74 Median $234.42 Typical High $398.11 | Professional | None | $1.74 | $234.42 | $398.11 |
Hometown Health Setting Professional Modifier None Typical Low $1.74 Median $1.74 Typical High $467.74 | Professional | None | $1.74 | $1.74 | $467.74 |
Select Health Setting Facility Modifier None Typical Low $309.03 Median $309.03 Typical High $4,265.80 | Facility | None | $309.03 | $309.03 | $4,265.80 |
Select Health Setting Professional Modifier None Typical Low $181.97 Median $275.42 Typical High $389.05 | Professional | None | $181.97 | $275.42 | $389.05 |
United Setting Professional Modifier None Typical Low $181.97 Median $245.47 Typical High $371.54 | Professional | None | $181.97 | $245.47 | $371.54 |
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 $151.36 Median $151.36 Typical High $165.96 | Professional | 52 · Reduced service | $151.36 | $151.36 | $165.96 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $60.26 Median $60.26 Typical High $66.07 | Professional | 53 · Discontinued | $60.26 | $60.26 | $66.07 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $45.71 Median $45.71 Typical High $48.98 | Professional | 55 · Aftercare only | $45.71 | $45.71 | $48.98 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $30.20 Median $30.20 Typical High $33.11 | Professional | 56 · Pre-op care only | $30.20 | $30.20 | $33.11 |
Where Nevada sits
The same service costs 2.8 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· 38th of 51
$288
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.