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 $66.07 Median $66.07 Typical High $75.86 | Facility | None | $66.07 | $66.07 | $75.86 |
Aetna Setting Professional Modifier None Typical Low $66.07 Median $66.07 Typical High $134.90 | Professional | None | $66.07 | $66.07 | $134.90 |
Ambetter Setting Professional Modifier None Typical Low $147.91 Median $147.91 Typical High $147.91 | Professional | None | $147.91 | $147.91 | $147.91 |
Anthem BCBS Setting Facility Modifier None Typical Low $199.53 Median $204.17 Typical High $275.42 | Facility | None | $199.53 | $204.17 | $275.42 |
Anthem BCBS Setting Professional Modifier None Typical Low $114.82 Median $120.23 Typical High $120.23 | Professional | None | $114.82 | $120.23 | $120.23 |
Anthem BCBS Setting Professional Modifier RR · Rental Typical Low $120.23 Median $120.23 Typical High $120.23 | Professional | RR · Rental | $120.23 | $120.23 | $120.23 |
Cigna Setting Facility Modifier None Typical Low $107.15 Median $125.89 Typical High $141.25 | Facility | None | $107.15 | $125.89 | $141.25 |
Cigna Setting Professional Modifier None Typical Low $93.33 Median $93.33 Typical High $125.89 | Professional | None | $93.33 | $93.33 | $125.89 |
Cigna Setting Professional Modifier RR · Rental Typical Low $10.72 Median $10.72 Typical High $12.59 | Professional | RR · Rental | $10.72 | $10.72 | $12.59 |
Hometown Health Setting Professional Modifier None Typical Low $128.82 Median $194.98 Typical High $331.13 | Professional | None | $128.82 | $194.98 | $331.13 |
Select Health Setting Facility Modifier None Typical Low $199.53 Median $199.53 Typical High $4,265.80 | Facility | None | $199.53 | $199.53 | $4,265.80 |
Select Health Setting Professional Modifier None Typical Low $125.89 Median $177.83 Typical High $204.17 | Professional | None | $125.89 | $177.83 | $204.17 |
United Setting Professional Modifier None Typical Low $85.11 Median $141.25 Typical High $213.80 | Professional | None | $85.11 | $141.25 | $213.80 |
5 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 $33.11 Median $33.11 Typical High $38.90 | Professional | 52 · Reduced service | $33.11 | $33.11 | $38.90 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $13.18 Median $13.18 Typical High $15.49 | Professional | 53 · Discontinued | $13.18 | $13.18 | $15.49 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $10.00 Median $10.00 Typical High $11.75 | Professional | 55 · Aftercare only | $10.00 | $10.00 | $11.75 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $6.61 Median $6.61 Typical High $7.76 | Professional | 56 · Pre-op care only | $6.61 | $6.61 | $7.76 |
Anthem BCBS Setting Professional Modifier UE · Used equipment Typical Low $87.10 Median $87.10 Typical High $87.10 | Professional | UE · Used equipment | $87.10 | $87.10 | $87.10 |
Where Nevada sits
The same service costs 2.1 times more in Hawaii than in Delaware. 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· 28th of 51
$126
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.