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 $89.13 | Facility | None | $64.57 | $66.07 | $89.13 |
Aetna Setting Professional Modifier None Typical Low $66.07 Median $87.10 Typical High $100.00 | Professional | None | $66.07 | $87.10 | $100.00 |
Aetna Setting Professional Modifier 52 · Reduced service Typical Low $33.11 Median $43.65 Typical High $44.67 | Professional | 52 · Reduced service | $33.11 | $43.65 | $44.67 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $10.00 Median $12.88 Typical High $13.49 | Professional | 55 · Aftercare only | $10.00 | $12.88 | $13.49 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $6.61 Median $8.71 Typical High $8.91 | Professional | 56 · Pre-op care only | $6.61 | $8.71 | $8.91 |
Ambetter Setting Professional Modifier None Typical Low $117.49 Median $117.49 Typical High $117.49 | Professional | None | $117.49 | $117.49 | $117.49 |
Anthem BCBS Setting Professional Modifier None Typical Low $83.18 Median $109.65 Typical High $162.18 | Professional | None | $83.18 | $109.65 | $162.18 |
Cigna Setting Professional Modifier None Typical Low $69.18 Median $93.33 Typical High $138.04 | Professional | None | $69.18 | $93.33 | $138.04 |
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 $72.44 Median $117.49 Typical High $4,265.80 | Facility | None | $72.44 | $117.49 | $4,265.80 |
Select Health Setting Professional Modifier None Typical Low $61.66 Median $70.79 Typical High $117.49 | Professional | None | $61.66 | $70.79 | $117.49 |
United Setting Professional Modifier None Typical Low $63.10 Median $83.18 Typical High $123.03 | Professional | None | $63.10 | $83.18 | $123.03 |
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 $100.00 Median $117.49 Typical High $117.49 | Professional | 25 · Same-day visit | $100.00 | $117.49 | $117.49 |
Ambetter Setting Professional Modifier EP · Child screening program Typical Low $125.89 Median $125.89 Typical High $125.89 | Professional | EP · Child screening program | $125.89 | $125.89 | $125.89 |
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
$89.13
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.