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 $758.58 Median $758.58 Typical High $1,949.84 | Facility | None | $758.58 | $758.58 | $1,949.84 |
Aetna Setting Professional Modifier None Typical Low $758.58 Median $758.58 Typical High $1,949.84 | Professional | None | $758.58 | $758.58 | $1,949.84 |
Ambetter Setting Professional Modifier None Typical Low $1,819.70 Median $1,819.70 Typical High $1,819.70 | Professional | None | $1,819.70 | $1,819.70 | $1,819.70 |
Anthem BCBS Setting Facility Modifier None Typical Low $2,398.83 Median $2,454.71 Typical High $3,388.44 | Facility | None | $2,398.83 | $2,454.71 | $3,388.44 |
Anthem BCBS Setting Professional Modifier None Typical Low $1,445.44 Median $1,445.44 Typical High $1,479.11 | Professional | None | $1,445.44 | $1,445.44 | $1,479.11 |
Cigna Setting Facility Modifier None Typical Low $1,348.96 Median $1,348.96 Typical High $1,479.11 | Facility | None | $1,348.96 | $1,348.96 | $1,479.11 |
Cigna Setting Professional Modifier None Typical Low $977.24 Median $977.24 Typical High $1,348.96 | Professional | None | $977.24 | $977.24 | $1,348.96 |
Hometown Health Setting Professional Modifier None Typical Low $1,380.38 Median $2,137.96 Typical High $4,073.80 | Professional | None | $1,380.38 | $2,137.96 | $4,073.80 |
Select Health Setting Facility Modifier None Typical Low $2,398.83 Median $2,398.83 Typical High $4,265.80 | Facility | None | $2,398.83 | $2,398.83 | $4,265.80 |
Select Health Setting Professional Modifier None Typical Low $1,513.56 Median $2,137.96 Typical High $2,511.89 | Professional | None | $1,513.56 | $2,137.96 | $2,511.89 |
United Setting Professional Modifier None Typical Low $1,023.29 Median $1,548.82 Typical High $2,398.83 | Professional | None | $1,023.29 | $1,548.82 | $2,398.83 |
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 $380.19 Median $380.19 Typical High $977.24 | Professional | 52 · Reduced service | $380.19 | $380.19 | $977.24 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $151.36 Median $151.36 Typical High $389.05 | Professional | 53 · Discontinued | $151.36 | $151.36 | $389.05 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $114.82 Median $114.82 Typical High $295.12 | Professional | 55 · Aftercare only | $114.82 | $114.82 | $295.12 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $75.86 Median $75.86 Typical High $194.98 | Professional | 56 · Pre-op care only | $75.86 | $75.86 | $194.98 |
Anthem BCBS Setting Professional Modifier RR · Rental Typical Low $1,318.26 Median $1,445.44 Typical High $1,445.44 | Professional | RR · Rental | $1,318.26 | $1,445.44 | $1,445.44 |
Anthem BCBS Setting Professional Modifier UE · Used equipment Typical Low $1,096.48 Median $1,096.48 Typical High $1,096.48 | Professional | UE · Used equipment | $1,096.48 | $1,096.48 | $1,096.48 |
Where Nevada sits
The same service costs 2.6 times more in Montana 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· 23rd of 51
$1,549
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.