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 $7.24 Median $7.24 Typical High $7.41 | Facility | None | $7.24 | $7.24 | $7.41 |
Aetna Setting Professional Modifier None Typical Low $7.24 Median $7.41 Typical High $7.41 | Professional | None | $7.24 | $7.41 | $7.41 |
Anthem BCBS Setting Professional Modifier None Typical Low $4.47 Median $4.47 Typical High $4.90 | Professional | None | $4.47 | $4.47 | $4.90 |
Cigna Setting Facility Modifier None Typical Low $5.01 Median $5.01 Typical High $5.37 | Facility | None | $5.01 | $5.01 | $5.37 |
Cigna Setting Professional Modifier None Typical Low $4.17 Median $4.27 Typical High $5.75 | Professional | None | $4.17 | $4.27 | $5.75 |
Hometown Health Setting Professional Modifier None Typical Low $5.13 Median $7.59 Typical High $14.45 | Professional | None | $5.13 | $7.59 | $14.45 |
Select Health Setting Facility Modifier None Typical Low $8.51 Median $8.51 Typical High $4,265.80 | Facility | None | $8.51 | $8.51 | $4,265.80 |
Select Health Setting Professional Modifier None Typical Low $5.50 Median $7.76 Typical High $8.51 | Professional | None | $5.50 | $7.76 | $8.51 |
United Setting Professional Modifier None Typical Low $3.31 Median $5.13 Typical High $8.51 | Professional | None | $3.31 | $5.13 | $8.51 |
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 55 · Aftercare only Typical Low $1.07 Median $1.10 Typical High $1.10 | Professional | 55 · Aftercare only | $1.07 | $1.10 | $1.10 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $0.72 Median $0.72 Typical High $0.72 | Professional | 56 · Pre-op care only | $0.72 | $0.72 | $0.72 |
Anthem BCBS Setting Professional Modifier RR · Rental Typical Low $4.17 Median $4.47 Typical High $4.47 | Professional | RR · Rental | $4.17 | $4.47 | $4.47 |
Anthem BCBS Setting Professional Modifier UE · Used equipment Typical Low $3.16 Median $3.16 Typical High $3.16 | Professional | UE · Used equipment | $3.16 | $3.16 | $3.16 |
Where Nevada sits
The same service costs 2.1 times more in Hawaii than in Delaware. 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· 26th of 51
$5.13
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.