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 $0.52 Median $0.52 Typical High $0.54 | Facility | None | $0.52 | $0.52 | $0.54 |
Aetna Setting Professional Modifier None Typical Low $0.34 Median $0.54 Typical High $0.54 | Professional | None | $0.34 | $0.54 | $0.54 |
Aetna Setting Professional Modifier RR · Rental Typical Low $0.05 Median $0.05 Typical High $0.05 | Professional | RR · Rental | $0.05 | $0.05 | $0.05 |
Anthem BCBS Setting Professional Modifier None Typical Low $0.22 Median $0.22 Typical High $0.22 | Professional | None | $0.22 | $0.22 | $0.22 |
Cigna Setting Professional Modifier None Typical Low $0.31 Median $0.31 Typical High $0.93 | Professional | None | $0.31 | $0.31 | $0.93 |
Hometown Health Setting Professional Modifier None Typical Low $0.51 Median $0.74 Typical High $1.10 | Professional | None | $0.51 | $0.74 | $1.10 |
Select Health Setting Facility Modifier None Typical Low $0.63 Median $0.63 Typical High $4,265.80 | Facility | None | $0.63 | $0.63 | $4,265.80 |
Select Health Setting Professional Modifier None Typical Low $0.40 Median $0.60 Typical High $0.79 | Professional | None | $0.40 | $0.60 | $0.79 |
United Setting Professional Modifier None Typical Low $0.25 Median $0.43 Typical High $0.72 | Professional | None | $0.25 | $0.43 | $0.72 |
4 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 |
|---|---|---|---|---|---|
Aetna Setting Professional Modifier 52 · Reduced service Typical Low $0.22 Median $0.27 Typical High $0.27 | Professional | 52 · Reduced service | $0.22 | $0.27 | $0.27 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $0.10 Median $0.11 Typical High $0.11 | Professional | 53 · Discontinued | $0.10 | $0.11 | $0.11 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $0.08 Median $0.08 Typical High $0.08 | Professional | 55 · Aftercare only | $0.08 | $0.08 | $0.08 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $0.05 Median $0.05 Typical High $0.05 | Professional | 56 · Pre-op care only | $0.05 | $0.05 | $0.05 |
Where Nevada sits
The same service costs 4.6 times more in Hawaii than in Rhode Island. 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· 15th of 51
$0.52
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.