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 $11.22 Median $13.49 Typical High $34.67 | Facility | None | $11.22 | $13.49 | $34.67 |
Aetna Setting Professional Modifier None Typical Low $8.13 Median $12.30 Typical High $13.49 | Professional | None | $8.13 | $12.30 | $13.49 |
Anthem BCBS Setting Facility Modifier None Typical Low $11.22 Median $12.88 Typical High $38.90 | Facility | None | $11.22 | $12.88 | $38.90 |
Anthem BCBS Setting Professional Modifier None Typical Low $12.30 Median $12.30 Typical High $12.30 | Professional | None | $12.30 | $12.30 | $12.30 |
Cigna Setting Facility Modifier None Typical Low $16.98 Median $27.54 Typical High $30.90 | Facility | None | $16.98 | $27.54 | $30.90 |
Cigna Setting Professional Modifier None Typical Low $12.30 Median $12.30 Typical High $48.98 | Professional | None | $12.30 | $12.30 | $48.98 |
Hometown Health Setting Professional Modifier None Typical Low $48.98 Median $48.98 Typical High $109.65 | Professional | None | $48.98 | $48.98 | $109.65 |
Select Health Setting Facility Modifier None Typical Low $12.30 Median $12.30 Typical High $12.30 | Facility | None | $12.30 | $12.30 | $12.30 |
Select Health Setting Professional Modifier None Typical Low $7.24 Median $12.30 Typical High $12.88 | Professional | None | $7.24 | $12.30 | $12.88 |
United Setting Professional Modifier None Typical Low $7.76 Median $9.33 Typical High $57.54 | Professional | None | $7.76 | $9.33 | $57.54 |
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 $4.07 Median $6.17 Typical High $6.76 | Professional | 52 · Reduced service | $4.07 | $6.17 | $6.76 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $1.62 Median $2.45 Typical High $2.69 | Professional | 53 · Discontinued | $1.62 | $2.45 | $2.69 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $1.23 Median $1.86 Typical High $2.00 | Professional | 55 · Aftercare only | $1.23 | $1.86 | $2.00 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $0.81 Median $1.23 Typical High $1.35 | Professional | 56 · Pre-op care only | $0.81 | $1.23 | $1.35 |
Where Nevada sits
The same service costs 6.3 times more in Wyoming 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· 19th of 51
$12.30
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.