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 $3.16 Median $3.16 Typical High $3.24 | Facility | None | $3.16 | $3.16 | $3.24 |
Aetna Setting Professional Modifier None Typical Low $2.45 Median $3.24 Typical High $3.24 | Professional | None | $2.45 | $3.24 | $3.24 |
Aetna Setting Professional Modifier 52 · Reduced service Typical Low $1.41 Median $1.62 Typical High $1.62 | Professional | 52 · Reduced service | $1.41 | $1.62 | $1.62 |
Anthem BCBS Setting Professional Modifier None Typical Low $0.89 Median $0.91 Typical High $4.37 | Professional | None | $0.89 | $0.91 | $4.37 |
Cigna Setting Professional Modifier None Typical Low $2.24 Median $2.24 Typical High $9.55 | Professional | None | $2.24 | $2.24 | $9.55 |
Hometown Health Setting Professional Modifier None Typical Low $3.09 Median $4.47 Typical High $6.46 | Professional | None | $3.09 | $4.47 | $6.46 |
Select Health Setting Facility Modifier None Typical Low $3.80 Median $3.80 Typical High $4,265.80 | Facility | None | $3.80 | $3.80 | $4,265.80 |
Select Health Setting Professional Modifier None Typical Low $2.40 Median $3.63 Typical High $4.79 | Professional | None | $2.40 | $3.63 | $4.79 |
United Setting Professional Modifier None Typical Low $1.78 Median $2.63 Typical High $5.25 | Professional | None | $1.78 | $2.63 | $5.25 |
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 53 · Discontinued Typical Low $0.60 Median $0.65 Typical High $0.65 | Professional | 53 · Discontinued | $0.60 | $0.65 | $0.65 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $0.47 Median $0.49 Typical High $0.49 | Professional | 55 · Aftercare only | $0.47 | $0.49 | $0.49 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $0.31 Median $0.33 Typical High $0.33 | Professional | 56 · Pre-op care only | $0.31 | $0.33 | $0.33 |
Aetna Setting Professional Modifier AU · Urologic/ostomy supply Typical Low $1.20 Median $1.20 Typical High $1.20 | Professional | AU · Urologic/ostomy supply | $1.20 | $1.20 | $1.20 |
Where Nevada sits
The same service costs 4.4 times more in Minnesota than in New Hampshire. 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· 13th of 51
$3.16
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.