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 $74.13 Median $75.86 Typical High $102.33 | Facility | None | $74.13 | $75.86 | $102.33 |
Aetna Setting Professional Modifier None Typical Low $75.86 Median $100.00 Typical High $114.82 | Professional | None | $75.86 | $100.00 | $114.82 |
Aetna Setting Professional Modifier 52 · Reduced service Typical Low $38.02 Median $48.98 Typical High $51.29 | Professional | 52 · Reduced service | $38.02 | $48.98 | $51.29 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $11.48 Median $14.79 Typical High $15.49 | Professional | 55 · Aftercare only | $11.48 | $14.79 | $15.49 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $7.59 Median $9.77 Typical High $10.23 | Professional | 56 · Pre-op care only | $7.59 | $9.77 | $10.23 |
Ambetter Setting Professional Modifier None Typical Low $114.82 Median $134.90 Typical High $134.90 | Professional | None | $114.82 | $134.90 | $134.90 |
Anthem BCBS Setting Professional Modifier None Typical Low $93.33 Median $125.89 Typical High $181.97 | Professional | None | $93.33 | $125.89 | $181.97 |
Cigna Setting Professional Modifier None Typical Low $77.62 Median $107.15 Typical High $158.49 | Professional | None | $77.62 | $107.15 | $158.49 |
Hometown Health Setting Professional Modifier None Typical Low $1.29 Median $1.29 Typical High $2.34 | Professional | None | $1.29 | $1.29 | $2.34 |
Hometown Health Setting Professional Modifier None Typical Low $1.29 Median $1.29 Typical High $1.29 | Professional | None | $1.29 | $1.29 | $1.29 |
Select Health Setting Facility Modifier None Typical Low $81.28 Median $134.90 Typical High $4,265.80 | Facility | None | $81.28 | $134.90 | $4,265.80 |
Select Health Setting Professional Modifier None Typical Low $69.18 Median $81.28 Typical High $134.90 | Professional | None | $69.18 | $81.28 | $134.90 |
United Setting Professional Modifier None Typical Low $52.48 Median $95.50 Typical High $138.04 | Professional | None | $52.48 | $95.50 | $138.04 |
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 $114.82 Median $114.82 Typical High $134.90 | Professional | 25 · Same-day visit | $114.82 | $114.82 | $134.90 |
Ambetter Setting Professional Modifier GC · Resident with teaching physician Typical Low $125.89 Median $165.96 Typical High $165.96 | Professional | GC · Resident with teaching physician | $125.89 | $165.96 | $165.96 |
Where Nevada sits
The same service costs 2.7 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
$102
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.