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 $11.75 Median $11.75 Typical High $13.49 | Facility | None | $11.75 | $11.75 | $13.49 |
Aetna Setting Professional Modifier None Typical Low $11.75 Median $11.75 Typical High $13.49 | Professional | None | $11.75 | $11.75 | $13.49 |
Anthem BCBS Setting Facility Modifier None Typical Low $35.48 Median $36.31 Typical High $48.98 | Facility | None | $35.48 | $36.31 | $48.98 |
Anthem BCBS Setting Professional Modifier None Typical Low $18.62 Median $18.62 Typical High $18.62 | Professional | None | $18.62 | $18.62 | $18.62 |
Cigna Setting Facility Modifier None Typical Low $24.55 Median $24.55 Typical High $26.92 | Facility | None | $24.55 | $24.55 | $26.92 |
Cigna Setting Professional Modifier None Typical Low $15.14 Median $17.78 Typical High $26.92 | Professional | None | $15.14 | $17.78 | $26.92 |
Hometown Health Setting Professional Modifier None Typical Low $22.91 Median $34.67 Typical High $58.88 | Professional | None | $22.91 | $34.67 | $58.88 |
Select Health Setting Facility Modifier None Typical Low $35.48 Median $35.48 Typical High $4,265.80 | Facility | None | $35.48 | $35.48 | $4,265.80 |
Select Health Setting Professional Modifier None Typical Low $22.39 Median $31.62 Typical High $36.31 | Professional | None | $22.39 | $31.62 | $36.31 |
United Setting Professional Modifier None Typical Low $14.79 Median $22.39 Typical High $35.48 | Professional | None | $14.79 | $22.39 | $35.48 |
6 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 $5.89 Median $5.89 Typical High $6.76 | Professional | 52 · Reduced service | $5.89 | $5.89 | $6.76 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $2.34 Median $2.34 Typical High $2.69 | Professional | 53 · Discontinued | $2.34 | $2.34 | $2.69 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $1.78 Median $1.78 Typical High $2.04 | Professional | 55 · Aftercare only | $1.78 | $1.78 | $2.04 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $1.17 Median $1.17 Typical High $1.35 | Professional | 56 · Pre-op care only | $1.17 | $1.17 | $1.35 |
Anthem BCBS Setting Professional Modifier RR · Rental Typical Low $18.62 Median $18.62 Typical High $19.05 | Professional | RR · Rental | $18.62 | $18.62 | $19.05 |
Anthem BCBS Setting Professional Modifier UE · Used equipment Typical Low $13.80 Median $13.80 Typical High $14.45 | Professional | UE · Used equipment | $13.80 | $13.80 | $14.45 |
Where Nevada sits
The same service costs 2.1 times more in Montana than in West Virginia. 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· 30th of 51
$20.89
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.