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 $57.54 Median $58.88 Typical High $85.11 | Facility | None | $57.54 | $58.88 | $85.11 |
Aetna Setting Professional Modifier None Typical Low $58.88 Median $83.18 Typical High $93.33 | Professional | None | $58.88 | $83.18 | $93.33 |
Aetna Setting Professional Modifier 52 · Reduced service Typical Low $29.51 Median $40.74 Typical High $42.66 | Professional | 52 · Reduced service | $29.51 | $40.74 | $42.66 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $8.91 Median $12.30 Typical High $12.88 | Professional | 55 · Aftercare only | $8.91 | $12.30 | $12.88 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $5.89 Median $8.13 Typical High $8.51 | Professional | 56 · Pre-op care only | $5.89 | $8.13 | $8.51 |
Ambetter Setting Professional Modifier None Typical Low $95.50 Median $95.50 Typical High $112.20 | Professional | None | $95.50 | $95.50 | $112.20 |
Anthem BCBS Setting Professional Modifier None Typical Low $72.44 Median $104.71 Typical High $147.91 | Professional | None | $72.44 | $104.71 | $147.91 |
Cigna Setting Professional Modifier None Typical Low $60.26 Median $89.13 Typical High $128.82 | Professional | None | $60.26 | $89.13 | $128.82 |
Hometown Health Setting Professional Modifier None Typical Low $0.95 Median $0.95 Typical High $1.51 | Professional | None | $0.95 | $0.95 | $1.51 |
Hometown Health Setting Professional Modifier None Typical Low $0.95 Median $0.95 Typical High $0.95 | Professional | None | $0.95 | $0.95 | $0.95 |
Select Health Setting Facility Modifier None Typical Low $63.10 Median $112.20 Typical High $4,265.80 | Facility | None | $63.10 | $112.20 | $4,265.80 |
Select Health Setting Professional Modifier None Typical Low $53.70 Median $69.18 Typical High $112.20 | Professional | None | $53.70 | $69.18 | $112.20 |
United Setting Professional Modifier None Typical Low $37.15 Median $74.13 Typical High $117.49 | Professional | None | $37.15 | $74.13 | $117.49 |
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 $95.50 Median $112.20 Typical High $165.96 | Professional | 25 · Same-day visit | $95.50 | $112.20 | $165.96 |
Ambetter Setting Professional Modifier EP · Child screening program Typical Low $95.50 Median $112.20 Typical High $112.20 | Professional | EP · Child screening program | $95.50 | $112.20 | $112.20 |
Where Nevada sits
The same service costs 2.9 times more in Alaska than in Washington, DC. 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· 47th of 51
$85.11
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.