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 $218.78 Median $218.78 Typical High $549.54 | Facility | None | $218.78 | $218.78 | $549.54 |
Aetna Setting Professional Modifier None Typical Low $218.78 Median $218.78 Typical High $549.54 | Professional | None | $218.78 | $218.78 | $549.54 |
Anthem BCBS Setting Professional Modifier None Typical Low $218.78 Median $288.40 Typical High $758.58 | Professional | None | $218.78 | $288.40 | $758.58 |
Cigna Setting Facility Modifier None Typical Low $371.54 Median $371.54 Typical High $398.11 | Facility | None | $371.54 | $371.54 | $398.11 |
Cigna Setting Professional Modifier None Typical Low $295.12 Median $316.23 Typical High $371.54 | Professional | None | $295.12 | $316.23 | $371.54 |
Hometown Health Setting Professional Modifier None Typical Low $389.05 Median $616.60 Typical High $1,148.15 | Professional | None | $389.05 | $616.60 | $1,148.15 |
Select Health Setting Facility Modifier None Typical Low $676.08 Median $676.08 Typical High $4,265.80 | Facility | None | $676.08 | $676.08 | $4,265.80 |
Select Health Setting Professional Modifier None Typical Low $436.52 Median $616.60 Typical High $676.08 | Professional | None | $436.52 | $616.60 | $676.08 |
United Setting Facility Modifier None Typical Low $331.13 Median $331.13 Typical High $331.13 | Facility | None | $331.13 | $331.13 | $331.13 |
United Setting Professional Modifier None Typical Low $288.40 Median $426.58 Typical High $676.08 | Professional | None | $288.40 | $426.58 | $676.08 |
4 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 $107.15 Median $107.15 Typical High $275.42 | Professional | 52 · Reduced service | $107.15 | $107.15 | $275.42 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $43.65 Median $43.65 Typical High $112.20 | Professional | 53 · Discontinued | $43.65 | $43.65 | $112.20 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $32.36 Median $32.36 Typical High $83.18 | Professional | 55 · Aftercare only | $32.36 | $32.36 | $83.18 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $21.88 Median $21.88 Typical High $54.95 | Professional | 56 · Pre-op care only | $21.88 | $21.88 | $54.95 |
Where Nevada sits
The same service costs 2.6 times more in Montana than in New York. 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· 29th of 51
$372
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.