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 $42.66 Median $60.26 Typical High $79.43 | Facility | None | $42.66 | $60.26 | $79.43 |
Aetna Setting Professional Modifier None Typical Low $42.66 Median $63.10 Typical High $79.43 | Professional | None | $42.66 | $63.10 | $79.43 |
Ambetter Setting Professional Modifier None Typical Low $63.10 Median $69.18 Typical High $83.18 | Professional | None | $63.10 | $69.18 | $83.18 |
Anthem BCBS Setting Professional Modifier None Typical Low $43.65 Median $64.57 Typical High $102.33 | Professional | None | $43.65 | $64.57 | $102.33 |
Cigna Setting Facility Modifier None Typical Low $104.71 Median $134.90 Typical High $194.98 | Facility | None | $104.71 | $134.90 | $194.98 |
Cigna Setting Professional Modifier None Typical Low $40.74 Median $60.26 Typical High $87.10 | Professional | None | $40.74 | $60.26 | $87.10 |
Hometown Health Setting Professional Modifier None Typical Low $44.67 Median $69.18 Typical High $95.50 | Professional | None | $44.67 | $69.18 | $95.50 |
Hometown Health Setting Professional Modifier None Typical Low $0.48 Median $61.66 Typical High $112.20 | Professional | None | $0.48 | $61.66 | $112.20 |
Select Health Setting Facility Modifier None Typical Low $40.74 Median $74.13 Typical High $4,265.80 | Facility | None | $40.74 | $74.13 | $4,265.80 |
Select Health Setting Professional Modifier None Typical Low $34.67 Median $45.71 Typical High $74.13 | Professional | None | $34.67 | $45.71 | $74.13 |
United Setting Professional Modifier None Typical Low $38.90 Median $61.66 Typical High $93.33 | Professional | None | $38.90 | $61.66 | $93.33 |
6 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 $21.38 Median $27.54 Typical High $31.62 | Professional | 52 · Reduced service | $21.38 | $27.54 | $31.62 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $6.46 Median $8.32 Typical High $9.55 | Professional | 55 · Aftercare only | $6.46 | $8.32 | $9.55 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $4.27 Median $5.50 Typical High $6.31 | Professional | 56 · Pre-op care only | $4.27 | $5.50 | $6.31 |
Ambetter Setting Professional Modifier 25 · Same-day visit Typical Low $63.10 Median $74.13 Typical High $75.86 | Professional | 25 · Same-day visit | $63.10 | $74.13 | $75.86 |
Ambetter Setting Professional Modifier 57 · Decision for surgery Typical Low $107.15 Median $107.15 Typical High $107.15 | Professional | 57 · Decision for surgery | $107.15 | $107.15 | $107.15 |
Ambetter Setting Professional Modifier 93 · Audio-only telehealth Typical Low $74.13 Median $74.13 Typical High $74.13 | Professional | 93 · Audio-only telehealth | $74.13 | $74.13 | $74.13 |
Where Nevada sits
The same service costs 2.2 times more in Alaska than in New Jersey. 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
$63.10
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.