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 $199.53 Median $4,897.79 Typical High $11,220.18 | Facility | None | $199.53 | $4,897.79 | $11,220.18 |
Aetna Setting Professional Modifier None Typical Low $190.55 Median $239.88 Typical High $257.04 | Professional | None | $190.55 | $239.88 | $257.04 |
Aetna Setting Professional Modifier 52 · Reduced service Typical Low $95.50 Median $104.71 Typical High $120.23 | Professional | 52 · Reduced service | $95.50 | $104.71 | $120.23 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $28.18 Median $31.62 Typical High $36.31 | Professional | 55 · Aftercare only | $28.18 | $31.62 | $36.31 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $19.05 Median $21.38 Typical High $23.99 | Professional | 56 · Pre-op care only | $19.05 | $21.38 | $23.99 |
Ambetter Setting Professional Modifier None Typical Low $165.96 Median $194.98 Typical High $489.78 | Professional | None | $165.96 | $194.98 | $489.78 |
Anthem BCBS Setting Facility Modifier None Typical Low $1,737.80 Median $4,677.35 Typical High $6,760.83 | Facility | None | $1,737.80 | $4,677.35 | $6,760.83 |
Anthem BCBS Setting Professional Modifier None Typical Low $165.96 Median $269.15 Typical High $467.74 | Professional | None | $165.96 | $269.15 | $467.74 |
Cigna Setting Facility Modifier None Typical Low $4,677.35 Median $5,370.32 Typical High $7,244.36 | Facility | None | $4,677.35 | $5,370.32 | $7,244.36 |
Cigna Setting Professional Modifier None Typical Low $173.78 Median $218.78 Typical High $346.74 | Professional | None | $173.78 | $218.78 | $346.74 |
Hometown Health Setting Professional Modifier None Typical Low $199.53 Median $251.19 Typical High $371.54 | Professional | None | $199.53 | $251.19 | $371.54 |
Hometown Health Setting Professional Modifier None Typical Low $2.09 Median $295.12 Typical High $457.09 | Professional | None | $2.09 | $295.12 | $457.09 |
Select Health Setting Facility Modifier None Typical Low $194.98 Median $309.03 Typical High $4,265.80 | Facility | None | $194.98 | $309.03 | $4,265.80 |
Select Health Setting Professional Modifier None Typical Low $165.96 Median $181.97 Typical High $380.19 | Professional | None | $165.96 | $181.97 | $380.19 |
United Setting Professional Modifier None Typical Low $158.49 Median $263.03 Typical High $371.54 | Professional | None | $158.49 | $263.03 | $371.54 |
2 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 |
|---|---|---|---|---|---|
Ambetter Setting Professional Modifier 25 · Same-day visit Typical Low $194.98 Median $194.98 Typical High $489.78 | Professional | 25 · Same-day visit | $194.98 | $194.98 | $489.78 |
Ambetter Setting Professional Modifier GC · Resident with teaching physician Typical Low $194.98 Median $194.98 Typical High $245.47 | Professional | GC · Resident with teaching physician | $194.98 | $194.98 | $245.47 |
Where Nevada sits
The same service costs 2.8 times more in Minnesota 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· 40th of 51
$240
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.