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 $144.54 Median $1,698.24 Typical High $4,365.16 | Facility | None | $144.54 | $1,698.24 | $4,365.16 |
Aetna Setting Professional Modifier None Typical Low $51.29 Median $131.83 Typical High $181.97 | Professional | None | $51.29 | $131.83 | $181.97 |
Ambetter Setting Professional Modifier None Typical Low $138.04 Median $138.04 Typical High $138.04 | Professional | None | $138.04 | $138.04 | $138.04 |
Anthem BCBS Setting Facility Modifier None Typical Low $2,238.72 Median $3,548.13 Typical High $4,466.84 | Facility | None | $2,238.72 | $3,548.13 | $4,466.84 |
Anthem BCBS Setting Professional Modifier None Typical Low $54.95 Median $141.25 Typical High $223.87 | Professional | None | $54.95 | $141.25 | $223.87 |
Cigna Setting Facility Modifier None Typical Low $120.23 Median $151.36 Typical High $912.01 | Facility | None | $120.23 | $151.36 | $912.01 |
Cigna Setting Professional Modifier None Typical Low $48.98 Median $123.03 Typical High $186.21 | Professional | None | $48.98 | $123.03 | $186.21 |
Hometown Health Setting Professional Modifier None Typical Low $50.12 Median $131.83 Typical High $229.09 | Professional | None | $50.12 | $131.83 | $229.09 |
Hometown Health Setting Facility Modifier None Typical Low $120.23 Median $120.23 Typical High $120.23 | Facility | None | $120.23 | $120.23 | $120.23 |
Hometown Health Setting Professional Modifier None Typical Low $0.89 Median $69.18 Typical High $223.87 | Professional | None | $0.89 | $69.18 | $223.87 |
Select Health Setting Facility Modifier None Typical Low $45.71 Median $151.36 Typical High $4,265.80 | Facility | None | $45.71 | $151.36 | $4,265.80 |
Select Health Setting Professional Modifier None Typical Low $47.86 Median $47.86 Typical High $47.86 | Professional | None | $47.86 | $47.86 | $47.86 |
United Setting Facility Modifier None Typical Low $302.00 Median $512.86 Typical High $2,137.96 | Facility | None | $302.00 | $512.86 | $2,137.96 |
United Setting Professional Modifier None Typical Low $58.88 Median $144.54 Typical High $199.53 | Professional | None | $58.88 | $144.54 | $199.53 |
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 $25.70 Median $43.65 Typical High $75.86 | Professional | 52 · Reduced service | $25.70 | $43.65 | $75.86 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $10.47 Median $17.38 Typical High $30.20 | Professional | 53 · Discontinued | $10.47 | $17.38 | $30.20 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $38.90 Median $66.07 Typical High $112.20 | Professional | 54 · Surgery only | $38.90 | $66.07 | $112.20 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $7.76 Median $13.18 Typical High $22.39 | Professional | 55 · Aftercare only | $7.76 | $13.18 | $22.39 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $5.25 Median $8.71 Typical High $15.14 | Professional | 56 · Pre-op care only | $5.25 | $8.71 | $15.14 |
Where Nevada sits
The same service costs 2.6 times more in Alaska than in Montana. 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
$148
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.