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 $33.11 Median $33.11 Typical High $38.02 | Facility | None | $33.11 | $33.11 | $38.02 |
Aetna Setting Professional Modifier None Typical Low $33.11 Median $33.11 Typical High $72.44 | Professional | None | $33.11 | $33.11 | $72.44 |
Ambetter Setting Professional Modifier None Typical Low $74.13 Median $74.13 Typical High $74.13 | Professional | None | $74.13 | $74.13 | $74.13 |
Anthem BCBS Setting Facility Modifier None Typical Low $97.72 Median $100.00 Typical High $138.04 | Facility | None | $97.72 | $100.00 | $138.04 |
Anthem BCBS Setting Professional Modifier None Typical Low $56.23 Median $57.54 Typical High $60.26 | Professional | None | $56.23 | $57.54 | $60.26 |
Cigna Setting Facility Modifier None Typical Low $60.26 Median $61.66 Typical High $67.61 | Facility | None | $60.26 | $61.66 | $67.61 |
Cigna Setting Professional Modifier None Typical Low $44.67 Median $44.67 Typical High $77.62 | Professional | None | $44.67 | $44.67 | $77.62 |
Hometown Health Setting Professional Modifier None Typical Low $63.10 Median $87.10 Typical High $165.96 | Professional | None | $63.10 | $87.10 | $165.96 |
Select Health Setting Facility Modifier None Typical Low $97.72 Median $97.72 Typical High $4,265.80 | Facility | None | $97.72 | $97.72 | $4,265.80 |
Select Health Setting Professional Modifier None Typical Low $61.66 Median $87.10 Typical High $107.15 | Professional | None | $61.66 | $87.10 | $107.15 |
United Setting Facility Modifier None Typical Low $72.44 Median $72.44 Typical High $72.44 | Facility | None | $72.44 | $72.44 | $72.44 |
United Setting Professional Modifier None Typical Low $45.71 Median $75.86 Typical High $123.03 | Professional | None | $45.71 | $75.86 | $123.03 |
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 $16.22 Median $16.22 Typical High $19.05 | Professional | 52 · Reduced service | $16.22 | $16.22 | $19.05 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $6.61 Median $6.61 Typical High $7.59 | Professional | 53 · Discontinued | $6.61 | $6.61 | $7.59 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $4.90 Median $4.90 Typical High $5.75 | Professional | 55 · Aftercare only | $4.90 | $4.90 | $5.75 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $3.31 Median $3.31 Typical High $3.80 | Professional | 56 · Pre-op care only | $3.31 | $3.31 | $3.80 |
Anthem BCBS Setting Professional Modifier RR · Rental Typical Low $57.54 Median $57.54 Typical High $57.54 | Professional | RR · Rental | $57.54 | $57.54 | $57.54 |
Anthem BCBS Setting Professional Modifier UE · Used equipment Typical Low $42.66 Median $42.66 Typical High $42.66 | Professional | UE · Used equipment | $42.66 | $42.66 | $42.66 |
Where Nevada sits
The same service costs 2.1 times more in Wisconsin than in New Jersey. 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· 32nd of 51
$61.66
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.