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 $41.69 Median $2,137.96 Typical High $10,715.19 | Facility | None | $41.69 | $2,137.96 | $10,715.19 |
Aetna Setting Professional Modifier None Typical Low $38.90 Median $72.44 Typical High $123.03 | Professional | None | $38.90 | $72.44 | $123.03 |
Ambetter Setting Professional Modifier None Typical Low $102.33 Median $131.83 Typical High $131.83 | Professional | None | $102.33 | $131.83 | $131.83 |
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 $44.67 Median $95.50 Typical High $169.82 | Professional | None | $44.67 | $95.50 | $169.82 |
Cigna Setting Facility Modifier None Typical Low $83.18 Median $95.50 Typical High $151.36 | Facility | None | $83.18 | $95.50 | $151.36 |
Cigna Setting Professional Modifier None Typical Low $36.31 Median $72.44 Typical High $141.25 | Professional | None | $36.31 | $72.44 | $141.25 |
Hometown Health Setting Professional Modifier None Typical Low $39.81 Median $95.50 Typical High $169.82 | Professional | None | $39.81 | $95.50 | $169.82 |
Hometown Health Setting Facility Modifier None Typical Low $87.10 Median $87.10 Typical High $87.10 | Facility | None | $87.10 | $87.10 | $87.10 |
Hometown Health Setting Professional Modifier None Typical Low $0.78 Median $53.70 Typical High $165.96 | Professional | None | $0.78 | $53.70 | $165.96 |
Select Health Setting Facility Modifier None Typical Low $36.31 Median $112.20 Typical High $4,265.80 | Facility | None | $36.31 | $112.20 | $4,265.80 |
Select Health Setting Professional Modifier None Typical Low $38.02 Median $38.02 Typical High $38.02 | Professional | None | $38.02 | $38.02 | $38.02 |
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 $41.69 Median $72.44 Typical High $144.54 | Professional | None | $41.69 | $72.44 | $144.54 |
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 $20.89 Median $34.67 Typical High $56.23 | Professional | 52 · Reduced service | $20.89 | $34.67 | $56.23 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $8.32 Median $13.80 Typical High $22.39 | Professional | 53 · Discontinued | $8.32 | $13.80 | $22.39 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $30.90 Median $52.48 Typical High $85.11 | Professional | 54 · Surgery only | $30.90 | $52.48 | $85.11 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $6.31 Median $10.47 Typical High $16.98 | Professional | 55 · Aftercare only | $6.31 | $10.47 | $16.98 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $4.17 Median $6.92 Typical High $11.22 | Professional | 56 · Pre-op care only | $4.17 | $6.92 | $11.22 |
Where Nevada sits
The same service costs 3.5 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· 27th of 51
$95.50
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.