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 $57.54 Median $57.54 Typical High $58.88 | Facility | None | $57.54 | $57.54 | $58.88 |
Aetna Setting Professional Modifier None Typical Low $57.54 Median $58.88 Typical High $58.88 | Professional | None | $57.54 | $58.88 | $58.88 |
Aetna Setting Professional Modifier 52 · Reduced service Typical Low $28.84 Median $29.51 Typical High $29.51 | Professional | 52 · Reduced service | $28.84 | $29.51 | $29.51 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $11.48 Median $12.02 Typical High $12.02 | Professional | 53 · Discontinued | $11.48 | $12.02 | $12.02 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $8.71 Median $8.91 Typical High $8.91 | Professional | 55 · Aftercare only | $8.71 | $8.91 | $8.91 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $5.75 Median $5.89 Typical High $5.89 | Professional | 56 · Pre-op care only | $5.75 | $5.89 | $5.89 |
Anthem BCBS Setting Facility Modifier None Typical Low $89.13 Median $91.20 Typical High $125.89 | Facility | None | $89.13 | $91.20 | $125.89 |
Anthem BCBS Setting Professional Modifier None Typical Low $40.74 Median $53.70 Typical High $426.58 | Professional | None | $40.74 | $53.70 | $426.58 |
Cigna Setting Facility Modifier None Typical Low $64.57 Median $64.57 Typical High $69.18 | Facility | None | $64.57 | $64.57 | $69.18 |
Cigna Setting Professional Modifier None Typical Low $53.70 Median $54.95 Typical High $54.95 | Professional | None | $53.70 | $54.95 | $54.95 |
Select Health Setting Facility Modifier None Typical Low $89.13 Median $89.13 Typical High $4,265.80 | Facility | None | $89.13 | $89.13 | $4,265.80 |
Select Health Setting Professional Modifier None Typical Low $70.79 Median $81.28 Typical High $100.00 | Professional | None | $70.79 | $81.28 | $100.00 |
United Setting Professional Modifier None Typical Low $38.02 Median $69.18 Typical High $107.15 | Professional | None | $38.02 | $69.18 | $107.15 |
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 |
|---|---|---|---|---|---|
Anthem BCBS Setting Professional Modifier RR · Rental Typical Low $9.33 Median $53.70 Typical High $53.70 | Professional | RR · Rental | $9.33 | $53.70 | $53.70 |
Anthem BCBS Setting Professional Modifier UE · Used equipment Typical Low $39.81 Median $39.81 Typical High $39.81 | Professional | UE · Used equipment | $39.81 | $39.81 | $39.81 |
Where Nevada sits
The same service costs 2.5 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· 27th of 51
$58.88
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.