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 $21.38 Median $2,137.96 Typical High $10,715.19 | Facility | None | $21.38 | $2,137.96 | $10,715.19 |
Aetna Setting Professional Modifier None Typical Low $21.38 Median $42.66 Typical High $83.18 | Professional | None | $21.38 | $42.66 | $83.18 |
Aetna Setting Professional Modifier 52 · Reduced service Typical Low $10.72 Median $20.89 Typical High $41.69 | Professional | 52 · Reduced service | $10.72 | $20.89 | $41.69 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $4.27 Median $10.00 Typical High $16.60 | Professional | 53 · Discontinued | $4.27 | $10.00 | $16.60 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $3.24 Median $7.41 Typical High $12.59 | Professional | 55 · Aftercare only | $3.24 | $7.41 | $12.59 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $2.14 Median $5.01 Typical High $8.32 | Professional | 56 · Pre-op care only | $2.14 | $5.01 | $8.32 |
Anthem BCBS Setting Professional Modifier None Typical Low $20.89 Median $58.88 Typical High $100.00 | Professional | None | $20.89 | $58.88 | $100.00 |
Cigna Setting Professional Modifier None Typical Low $33.11 Median $74.13 Typical High $74.13 | Professional | None | $33.11 | $74.13 | $74.13 |
Hometown Health Setting Professional Modifier None Typical Low $19.05 Median $58.88 Typical High $97.72 | Professional | None | $19.05 | $58.88 | $97.72 |
Hometown Health Setting Professional Modifier None Typical Low $0.20 Median $28.18 Typical High $120.23 | Professional | None | $0.20 | $28.18 | $120.23 |
Select Health Setting Facility Modifier None Typical Low $19.05 Median $81.28 Typical High $4,265.80 | Facility | None | $19.05 | $81.28 | $4,265.80 |
Select Health Setting Professional Modifier None Typical Low $16.22 Median $24.55 Typical High $81.28 | Professional | None | $16.22 | $24.55 | $81.28 |
United Setting Professional Modifier None Typical Low $22.39 Median $45.71 Typical High $104.71 | Professional | None | $22.39 | $45.71 | $104.71 |
1 more rate 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 59 · Distinct service Typical Low $50.12 Median $50.12 Typical High $50.12 | Professional | 59 · Distinct service | $50.12 | $50.12 | $50.12 |
Where Nevada sits
The same service costs 6.5 times more in Alaska than in Indiana. 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· 40th of 51
$52.48
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.