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 $31.62 Median $2,137.96 Typical High $10,715.19 | Facility | None | $31.62 | $2,137.96 | $10,715.19 |
Aetna Setting Professional Modifier None Typical Low $26.92 Median $58.88 Typical High $107.15 | Professional | None | $26.92 | $58.88 | $107.15 |
Ambetter Setting Professional Modifier None Typical Low $48.98 Median $48.98 Typical High $48.98 | Professional | None | $48.98 | $48.98 | $48.98 |
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 $33.11 Median $75.86 Typical High $147.91 | Professional | None | $33.11 | $75.86 | $147.91 |
Cigna Setting Facility Modifier None Typical Low $54.95 Median $741.31 Typical High $2,137.96 | Facility | None | $54.95 | $741.31 | $2,137.96 |
Cigna Setting Professional Modifier None Typical Low $25.12 Median $54.95 Typical High $123.03 | Professional | None | $25.12 | $54.95 | $123.03 |
Hometown Health Setting Professional Modifier None Typical Low $30.20 Median $74.13 Typical High $144.54 | Professional | None | $30.20 | $74.13 | $144.54 |
Hometown Health Setting Professional Modifier None Typical Low $0.60 Median $40.74 Typical High $144.54 | Professional | None | $0.60 | $40.74 | $144.54 |
Select Health Setting Facility Modifier None Typical Low $27.54 Median $95.50 Typical High $4,265.80 | Facility | None | $27.54 | $95.50 | $4,265.80 |
Select Health Setting Professional Modifier None Typical Low $28.84 Median $28.84 Typical High $28.84 | Professional | None | $28.84 | $28.84 | $28.84 |
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 $28.84 Median $58.88 Typical High $125.89 | Professional | None | $28.84 | $58.88 | $125.89 |
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 $15.49 Median $26.30 Typical High $48.98 | Professional | 52 · Reduced service | $15.49 | $26.30 | $48.98 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $6.31 Median $10.47 Typical High $19.50 | Professional | 53 · Discontinued | $6.31 | $10.47 | $19.50 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $23.44 Median $38.90 Typical High $74.13 | Professional | 54 · Surgery only | $23.44 | $38.90 | $74.13 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $4.68 Median $7.94 Typical High $14.79 | Professional | 55 · Aftercare only | $4.68 | $7.94 | $14.79 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $3.16 Median $5.25 Typical High $9.77 | Professional | 56 · Pre-op care only | $3.16 | $5.25 | $9.77 |
Where Nevada sits
The same service costs 3.3 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· 36th of 51
$74.13
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.