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 $251.19 Median $251.19 Typical High $1,023.29 | Facility | None | $251.19 | $251.19 | $1,023.29 |
Aetna Setting Professional Modifier None Typical Low $251.19 Median $251.19 Typical High $257.04 | Professional | None | $251.19 | $251.19 | $257.04 |
Anthem BCBS Setting Facility Modifier None Typical Low $223.87 Median $257.04 Typical High $316.23 | Facility | None | $223.87 | $257.04 | $316.23 |
Anthem BCBS Setting Professional Modifier None Typical Low $218.78 Median $218.78 Typical High $251.19 | Professional | None | $218.78 | $218.78 | $251.19 |
Cigna Setting Facility Modifier None Typical Low $251.19 Median $389.05 Typical High $630.96 | Facility | None | $251.19 | $389.05 | $630.96 |
Cigna Setting Professional Modifier None Typical Low $257.04 Median $257.04 Typical High $257.04 | Professional | None | $257.04 | $257.04 | $257.04 |
Hometown Health Setting Professional Modifier None Typical Low $208.93 Median $257.04 Typical High $302.00 | Professional | None | $208.93 | $257.04 | $302.00 |
Select Health Setting Professional Modifier None Typical Low $251.19 Median $251.19 Typical High $269.15 | Professional | None | $251.19 | $251.19 | $269.15 |
United Setting Professional Modifier None Typical Low $162.18 Median $251.19 Typical High $302.00 | Professional | None | $162.18 | $251.19 | $302.00 |
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 $125.89 Median $125.89 Typical High $128.82 | Professional | 52 · Reduced service | $125.89 | $125.89 | $128.82 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $50.12 Median $50.12 Typical High $51.29 | Professional | 53 · Discontinued | $50.12 | $50.12 | $51.29 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $37.15 Median $37.15 Typical High $38.02 | Professional | 55 · Aftercare only | $37.15 | $37.15 | $38.02 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $25.12 Median $25.12 Typical High $25.70 | Professional | 56 · Pre-op care only | $25.12 | $25.12 | $25.70 |
Where Nevada sits
The same service costs 4.1 times more in Alaska than in Montana. 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
$251
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.