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 $4.17 Median $4.17 Typical High $10.72 | Facility | None | $4.17 | $4.17 | $10.72 |
Aetna Setting Professional Modifier None Typical Low $4.17 Median $4.17 Typical High $10.72 | Professional | None | $4.17 | $4.17 | $10.72 |
Anthem BCBS Setting Facility Modifier None Typical Low $12.88 Median $13.49 Typical High $18.20 | Facility | None | $12.88 | $13.49 | $18.20 |
Anthem BCBS Setting Professional Modifier None Typical Low $6.61 Median $6.92 Typical High $6.92 | Professional | None | $6.61 | $6.92 | $6.92 |
Cigna Setting Facility Modifier None Typical Low $7.08 Median $7.08 Typical High $7.94 | Facility | None | $7.08 | $7.08 | $7.94 |
Cigna Setting Professional Modifier None Typical Low $5.25 Median $5.25 Typical High $9.33 | Professional | None | $5.25 | $5.25 | $9.33 |
Hometown Health Setting Professional Modifier None Typical Low $7.41 Median $11.75 Typical High $21.88 | Professional | None | $7.41 | $11.75 | $21.88 |
Select Health Setting Facility Modifier None Typical Low $12.88 Median $12.88 Typical High $4,265.80 | Facility | None | $12.88 | $12.88 | $4,265.80 |
Select Health Setting Professional Modifier None Typical Low $8.32 Median $11.75 Typical High $15.14 | Professional | None | $8.32 | $11.75 | $15.14 |
United Setting Facility Modifier None Typical Low $6.31 Median $6.31 Typical High $7.94 | Facility | None | $6.31 | $6.31 | $7.94 |
United Setting Professional Modifier None Typical Low $5.25 Median $7.94 Typical High $12.88 | Professional | None | $5.25 | $7.94 | $12.88 |
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 $2.04 Median $2.04 Typical High $5.25 | Professional | 52 · Reduced service | $2.04 | $2.04 | $5.25 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $0.83 Median $0.83 Typical High $2.14 | Professional | 53 · Discontinued | $0.83 | $0.83 | $2.14 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $0.62 Median $0.62 Typical High $1.58 | Professional | 55 · Aftercare only | $0.62 | $0.62 | $1.58 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $0.41 Median $0.41 Typical High $1.07 | Professional | 56 · Pre-op care only | $0.41 | $0.41 | $1.07 |
Anthem BCBS Setting Professional Modifier RR · Rental Typical Low $6.76 Median $6.92 Typical High $6.92 | Professional | RR · Rental | $6.76 | $6.92 | $6.92 |
Anthem BCBS Setting Professional Modifier UE · Used equipment Typical Low $5.01 Median $5.01 Typical High $5.01 | Professional | UE · Used equipment | $5.01 | $5.01 | $5.01 |
Where Nevada sits
The same service costs 3.5 times more in Montana than in Kansas. 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· 24th of 51
$7.94
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.