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 $117.49 Median $144.54 Typical High $173.78 | Facility | None | $117.49 | $144.54 | $173.78 |
Aetna Setting Professional Modifier None Typical Low $117.49 Median $144.54 Typical High $173.78 | Professional | None | $117.49 | $144.54 | $173.78 |
Ambetter Setting Professional Modifier None Typical Low $114.82 Median $177.83 Typical High $263.03 | Professional | None | $114.82 | $177.83 | $263.03 |
Anthem BCBS Setting Professional Modifier None Typical Low $112.20 Median $158.49 Typical High $245.47 | Professional | None | $112.20 | $158.49 | $245.47 |
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 $104.71 Median $131.83 Typical High $199.53 | Professional | None | $104.71 | $131.83 | $199.53 |
Hometown Health Setting Professional Modifier None Typical Low $102.33 Median $144.54 Typical High $208.93 | Professional | None | $102.33 | $144.54 | $208.93 |
Hometown Health Setting Professional Modifier None Typical Low $1.00 Median $128.82 Typical High $263.03 | Professional | None | $1.00 | $128.82 | $263.03 |
Select Health Setting Facility Modifier None Typical Low $114.82 Median $177.83 Typical High $4,265.80 | Facility | None | $114.82 | $177.83 | $4,265.80 |
Select Health Setting Professional Modifier None Typical Low $97.72 Median $107.15 Typical High $177.83 | Professional | None | $97.72 | $107.15 | $177.83 |
United Setting Professional Modifier None Typical Low $74.13 Median $144.54 Typical High $213.80 | Professional | None | $74.13 | $144.54 | $213.80 |
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 $58.88 Median $64.57 Typical High $72.44 | Professional | 52 · Reduced service | $58.88 | $64.57 | $72.44 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $17.78 Median $19.50 Typical High $21.88 | Professional | 55 · Aftercare only | $17.78 | $19.50 | $21.88 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $11.75 Median $12.88 Typical High $14.45 | Professional | 56 · Pre-op care only | $11.75 | $12.88 | $14.45 |
Ambetter Setting Professional Modifier 25 · Same-day visit Typical Low $114.82 Median $177.83 Typical High $263.03 | Professional | 25 · Same-day visit | $114.82 | $177.83 | $263.03 |
Ambetter Setting Professional Modifier GC · Resident with teaching physician Typical Low $151.36 Median $177.83 Typical High $218.78 | Professional | GC · Resident with teaching physician | $151.36 | $177.83 | $218.78 |
Where Nevada sits
The same service costs 2.3 times more in Alaska than in Alabama. 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· 32nd of 51
$145
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.