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 $56.23 Median $2,137.96 Typical High $10,715.19 | Facility | None | $56.23 | $2,137.96 | $10,715.19 |
Aetna Setting Professional Modifier None Typical Low $53.70 Median $91.20 Typical High $144.54 | Professional | None | $53.70 | $91.20 | $144.54 |
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 $60.26 Median $128.82 Typical High $204.17 | Professional | None | $60.26 | $128.82 | $204.17 |
Cigna Setting Facility Modifier None Typical Low $93.33 Median $107.15 Typical High $165.96 | Facility | None | $93.33 | $107.15 | $165.96 |
Cigna Setting Professional Modifier None Typical Low $52.48 Median $89.13 Typical High $154.88 | Professional | None | $52.48 | $89.13 | $154.88 |
Hometown Health Setting Professional Modifier None Typical Low $54.95 Median $107.15 Typical High $199.53 | Professional | None | $54.95 | $107.15 | $199.53 |
Hometown Health Setting Facility Modifier None Typical Low $97.72 Median $97.72 Typical High $97.72 | Facility | None | $97.72 | $97.72 | $97.72 |
Hometown Health Setting Professional Modifier None Typical Low $1.07 Median $75.86 Typical High $199.53 | Professional | None | $1.07 | $75.86 | $199.53 |
Select Health Setting Facility Modifier None Typical Low $50.12 Median $131.83 Typical High $4,265.80 | Facility | None | $50.12 | $131.83 | $4,265.80 |
Select Health Setting Professional Modifier None Typical Low $52.48 Median $52.48 Typical High $52.48 | Professional | None | $52.48 | $52.48 | $52.48 |
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 $58.88 Median $93.33 Typical High $169.82 | Professional | None | $58.88 | $93.33 | $169.82 |
6 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 $28.18 Median $43.65 Typical High $66.07 | Professional | 52 · Reduced service | $28.18 | $43.65 | $66.07 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $11.22 Median $17.38 Typical High $26.30 | Professional | 53 · Discontinued | $11.22 | $17.38 | $26.30 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $42.66 Median $64.57 Typical High $100.00 | Professional | 54 · Surgery only | $42.66 | $64.57 | $100.00 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $8.51 Median $13.18 Typical High $19.95 | Professional | 55 · Aftercare only | $8.51 | $13.18 | $19.95 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $5.62 Median $8.71 Typical High $13.18 | Professional | 56 · Pre-op care only | $5.62 | $8.71 | $13.18 |
Ambetter Setting Professional Modifier 59 · Distinct service Typical Low $144.54 Median $144.54 Typical High $144.54 | Professional | 59 · Distinct service | $144.54 | $144.54 | $144.54 |
Where Nevada sits
The same service costs 3.2 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· 33rd of 51
$110
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.