How much rates vary
Distribution of negotiated rates across all payers (price axis is log-scale). 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 $47.86 Median $1,698.24 Typical High $4,365.16 | Facility | None | $47.86 | $1,698.24 | $4,365.16 |
Aetna Setting Professional Modifier None Typical Low $46.77 Median $54.95 Typical High $67.61 | Professional | None | $46.77 | $54.95 | $67.61 |
Anthem BCBS Setting Professional Modifier None Typical Low $48.98 Median $67.61 Typical High $107.15 | Professional | None | $48.98 | $67.61 | $107.15 |
Cigna Setting Facility Modifier None Typical Low $562.34 Median $758.58 Typical High $2,137.96 | Facility | None | $562.34 | $758.58 | $2,137.96 |
Cigna Setting Professional Modifier None Typical Low $39.81 Median $51.29 Typical High $85.11 | Professional | None | $39.81 | $51.29 | $85.11 |
Hometown Health Setting Professional Modifier None Typical Low $43.65 Median $60.26 Typical High $95.50 | Professional | None | $43.65 | $60.26 | $95.50 |
Hometown Health Setting Professional Modifier None Typical Low $0.48 Median $63.10 Typical High $89.13 | Professional | None | $0.48 | $63.10 | $89.13 |
Select Health Setting Facility Modifier None Typical Low $42.66 Median $58.88 Typical High $4,265.80 | Facility | None | $42.66 | $58.88 | $4,265.80 |
Select Health Setting Professional Modifier None Typical Low $53.70 Median $53.70 Typical High $53.70 | Professional | None | $53.70 | $53.70 | $53.70 |
United Setting Facility Modifier None Typical Low $97.72 Median $245.47 Typical High $1,949.84 | Facility | None | $97.72 | $245.47 | $1,949.84 |
United Setting Professional Modifier None Typical Low $48.98 Median $63.10 Typical High $93.33 | Professional | None | $48.98 | $63.10 | $93.33 |
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 $22.91 Median $26.30 Typical High $28.84 | Professional | 52 · Reduced service | $22.91 | $26.30 | $28.84 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $9.33 Median $10.47 Typical High $11.48 | Professional | 53 · Discontinued | $9.33 | $10.47 | $11.48 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $34.67 Median $38.90 Typical High $43.65 | Professional | 54 · Surgery only | $34.67 | $38.90 | $43.65 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $6.92 Median $7.76 Typical High $8.71 | Professional | 55 · Aftercare only | $6.92 | $7.76 | $8.71 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $4.68 Median $5.25 Typical High $5.75 | Professional | 56 · Pre-op care only | $4.68 | $5.25 | $5.75 |
Where Nevada sits
The same service costs 4.8 times more in Alaska than in Kentucky. 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· 47th 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.