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 $95.50 Median $3,715.35 Typical High $12,589.25 | Facility | None | $95.50 | $3,715.35 | $12,589.25 |
Aetna Setting Professional Modifier None Typical Low $95.50 Median $107.15 Typical High $117.49 | Professional | None | $95.50 | $107.15 | $117.49 |
Aetna Setting Professional Modifier 52 · Reduced service Typical Low $47.86 Median $50.12 Typical High $52.48 | Professional | 52 · Reduced service | $47.86 | $50.12 | $52.48 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $14.13 Median $15.14 Typical High $15.85 | Professional | 55 · Aftercare only | $14.13 | $15.14 | $15.85 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $9.55 Median $10.00 Typical High $10.72 | Professional | 56 · Pre-op care only | $9.55 | $10.00 | $10.72 |
Ambetter Setting Professional Modifier None Typical Low $81.28 Median $223.87 Typical High $223.87 | Professional | None | $81.28 | $223.87 | $223.87 |
Anthem BCBS Setting Facility Modifier None Typical Low $1,737.80 Median $3,388.44 Typical High $6,025.60 | Facility | None | $1,737.80 | $3,388.44 | $6,025.60 |
Anthem BCBS Setting Professional Modifier None Typical Low $104.71 Median $128.82 Typical High $213.80 | Professional | None | $104.71 | $128.82 | $213.80 |
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 $87.10 Median $97.72 Typical High $158.49 | Professional | None | $87.10 | $97.72 | $158.49 |
Hometown Health Setting Professional Modifier None Typical Low $100.00 Median $114.82 Typical High $169.82 | Professional | None | $100.00 | $114.82 | $169.82 |
Hometown Health Setting Professional Modifier None Typical Low $1.05 Median $147.91 Typical High $199.53 | Professional | None | $1.05 | $147.91 | $199.53 |
Select Health Setting Facility Modifier None Typical Low $100.00 Median $131.83 Typical High $4,265.80 | Facility | None | $100.00 | $131.83 | $4,265.80 |
Select Health Setting Professional Modifier None Typical Low $74.13 Median $91.20 Typical High $194.98 | Professional | None | $74.13 | $91.20 | $194.98 |
United Setting Professional Modifier None Typical Low $69.18 Median $117.49 Typical High $169.82 | Professional | None | $69.18 | $117.49 | $169.82 |
1 more rate 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 $100.00 Median $100.00 Typical High $223.87 | Professional | 25 · Same-day visit | $100.00 | $100.00 | $223.87 |
Where Nevada sits
The same service costs 2.7 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· 36th of 51
$115
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.