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 $15.49 Median $18.62 Typical High $194.98 | Facility | None | $15.49 | $18.62 | $194.98 |
Aetna Setting Professional Modifier None Typical Low $15.49 Median $147.91 Typical High $194.98 | Professional | None | $15.49 | $147.91 | $194.98 |
Aetna Setting Professional Modifier 52 · Reduced service Typical Low $7.76 Median $9.33 Typical High $67.61 | Professional | 52 · Reduced service | $7.76 | $9.33 | $67.61 |
Ambetter Setting Professional Modifier None Typical Low $134.90 Median $165.96 Typical High $239.88 | Professional | None | $134.90 | $165.96 | $239.88 |
Anthem BCBS Setting Professional Modifier None Typical Low $104.71 Median $120.23 Typical High $154.88 | Professional | None | $104.71 | $120.23 | $154.88 |
Cigna Setting Professional Modifier None Typical Low $123.03 Median $144.54 Typical High $223.87 | Professional | None | $123.03 | $144.54 | $223.87 |
Hometown Health Setting Professional Modifier None Typical Low $1.41 Median $1.41 Typical High $186.21 | Professional | None | $1.41 | $1.41 | $186.21 |
Hometown Health Setting Professional Modifier None Typical Low $1.41 Median $1.41 Typical High $1.41 | Professional | None | $1.41 | $1.41 | $1.41 |
Select Health Setting Facility Modifier None Typical Low $131.83 Median $158.49 Typical High $4,265.80 | Facility | None | $131.83 | $158.49 | $4,265.80 |
Select Health Setting Professional Modifier None Typical Low $100.00 Median $123.03 Typical High $199.53 | Professional | None | $100.00 | $123.03 | $199.53 |
United Setting Professional Modifier None Typical Low $125.89 Median $165.96 Typical High $234.42 | Professional | None | $125.89 | $165.96 | $234.42 |
3 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 55 · Aftercare only Typical Low $17.38 Median $21.88 Typical High $27.54 | Professional | 55 · Aftercare only | $17.38 | $21.88 | $27.54 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $11.48 Median $14.45 Typical High $18.20 | Professional | 56 · Pre-op care only | $11.48 | $14.45 | $18.20 |
Ambetter Setting Professional Modifier 25 · Same-day visit Typical Low $158.49 Median $165.96 Typical High $245.47 | Professional | 25 · Same-day visit | $158.49 | $165.96 | $245.47 |
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· 34th of 51
$155
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.