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 $64.57 Median $66.07 Typical High $93.33 | Facility | None | $64.57 | $66.07 | $93.33 |
Aetna Setting Professional Modifier None Typical Low $66.07 Median $91.20 Typical High $104.71 | Professional | None | $66.07 | $91.20 | $104.71 |
Aetna Setting Professional Modifier 52 · Reduced service Typical Low $33.11 Median $44.67 Typical High $46.77 | Professional | 52 · Reduced service | $33.11 | $44.67 | $46.77 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $10.00 Median $13.49 Typical High $13.80 | Professional | 55 · Aftercare only | $10.00 | $13.49 | $13.80 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $6.61 Median $8.91 Typical High $9.33 | Professional | 56 · Pre-op care only | $6.61 | $8.91 | $9.33 |
Ambetter Setting Professional Modifier None Typical Low $104.71 Median $123.03 Typical High $123.03 | Professional | None | $104.71 | $123.03 | $123.03 |
Anthem BCBS Setting Professional Modifier None Typical Low $83.18 Median $114.82 Typical High $165.96 | Professional | None | $83.18 | $114.82 | $165.96 |
Cigna Setting Professional Modifier None Typical Low $69.18 Median $97.72 Typical High $141.25 | Professional | None | $69.18 | $97.72 | $141.25 |
Hometown Health Setting Professional Modifier None Typical Low $1.10 Median $1.10 Typical High $1.78 | Professional | None | $1.10 | $1.10 | $1.78 |
Hometown Health Setting Professional Modifier None Typical Low $1.10 Median $1.10 Typical High $1.10 | Professional | None | $1.10 | $1.10 | $1.10 |
Select Health Setting Facility Modifier None Typical Low $72.44 Median $123.03 Typical High $4,265.80 | Facility | None | $72.44 | $123.03 | $4,265.80 |
Select Health Setting Professional Modifier None Typical Low $61.66 Median $74.13 Typical High $123.03 | Professional | None | $61.66 | $74.13 | $123.03 |
United Setting Professional Modifier None Typical Low $63.10 Median $85.11 Typical High $125.89 | Professional | None | $63.10 | $85.11 | $125.89 |
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 $104.71 Median $104.71 Typical High $123.03 | Professional | 25 · Same-day visit | $104.71 | $104.71 | $123.03 |
Ambetter Setting Professional Modifier EP · Child screening program Typical Low $104.71 Median $104.71 Typical High $104.71 | Professional | EP · Child screening program | $104.71 | $104.71 | $104.71 |
Where Nevada sits
The same service costs 2.8 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· 46th of 51
$93.33
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.