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 $31.62 Median $38.90 Typical High $52.48 | Facility | None | $31.62 | $38.90 | $52.48 |
Aetna Setting Professional Modifier None Typical Low $31.62 Median $41.69 Typical High $51.29 | Professional | None | $31.62 | $41.69 | $51.29 |
Ambetter Setting Professional Modifier None Typical Low $50.12 Median $58.88 Typical High $89.13 | Professional | None | $50.12 | $58.88 | $89.13 |
Anthem BCBS Setting Professional Modifier None Typical Low $21.88 Median $46.77 Typical High $75.86 | Professional | None | $21.88 | $46.77 | $75.86 |
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 $20.89 Median $35.48 Typical High $58.88 | Professional | None | $20.89 | $35.48 | $58.88 |
Hometown Health Setting Professional Modifier None Typical Low $22.91 Median $40.74 Typical High $70.79 | Professional | None | $22.91 | $40.74 | $70.79 |
Hometown Health Setting Professional Modifier None Typical Low $0.30 Median $45.71 Typical High $89.13 | Professional | None | $0.30 | $45.71 | $89.13 |
Select Health Setting Facility Modifier None Typical Low $30.90 Median $58.88 Typical High $4,265.80 | Facility | None | $30.90 | $58.88 | $4,265.80 |
Select Health Setting Professional Modifier None Typical Low $23.44 Median $35.48 Typical High $58.88 | Professional | None | $23.44 | $35.48 | $58.88 |
United Setting Professional Modifier None Typical Low $19.95 Median $40.74 Typical High $72.44 | Professional | None | $19.95 | $40.74 | $72.44 |
9 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 $15.85 Median $18.20 Typical High $24.55 | Professional | 52 · Reduced service | $15.85 | $18.20 | $24.55 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $4.79 Median $5.50 Typical High $7.41 | Professional | 55 · Aftercare only | $4.79 | $5.50 | $7.41 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $3.16 Median $3.63 Typical High $4.90 | Professional | 56 · Pre-op care only | $3.16 | $3.63 | $4.90 |
Ambetter Setting Professional Modifier 24 · Unrelated visit after surgery Typical Low $70.79 Median $70.79 Typical High $70.79 | Professional | 24 · Unrelated visit after surgery | $70.79 | $70.79 | $70.79 |
Ambetter Setting Professional Modifier 25 · Same-day visit Typical Low $50.12 Median $58.88 Typical High $64.57 | Professional | 25 · Same-day visit | $50.12 | $58.88 | $64.57 |
Ambetter Setting Professional Modifier 57 · Decision for surgery Typical Low $58.88 Median $58.88 Typical High $58.88 | Professional | 57 · Decision for surgery | $58.88 | $58.88 | $58.88 |
Ambetter Setting Professional Modifier 93 · Audio-only telehealth Typical Low $56.23 Median $58.88 Typical High $69.18 | Professional | 93 · Audio-only telehealth | $56.23 | $58.88 | $69.18 |
Ambetter Setting Professional Modifier GC · Resident with teaching physician Typical Low $58.88 Median $58.88 Typical High $58.88 | Professional | GC · Resident with teaching physician | $58.88 | $58.88 | $58.88 |
Ambetter Setting Professional Modifier SA · Nurse practitioner Typical Low $58.88 Median $58.88 Typical High $58.88 | Professional | SA · Nurse practitioner | $58.88 | $58.88 | $58.88 |
Where Nevada sits
The same service costs 2.4 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· 34th of 51
$41.69
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.