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 $67.61 Median $2,137.96 Typical High $10,715.19 | Facility | None | $67.61 | $2,137.96 | $10,715.19 |
Aetna Setting Professional Modifier None Typical Low $64.57 Median $104.71 Typical High $165.96 | Professional | None | $64.57 | $104.71 | $165.96 |
Ambetter Setting Professional Modifier None Typical Low $114.82 Median $114.82 Typical High $114.82 | Professional | None | $114.82 | $114.82 | $114.82 |
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 $70.79 Median $151.36 Typical High $234.42 | Professional | None | $70.79 | $151.36 | $234.42 |
Cigna Setting Facility Modifier None Typical Low $104.71 Median $120.23 Typical High $186.21 | Facility | None | $104.71 | $120.23 | $186.21 |
Cigna Setting Professional Modifier None Typical Low $60.26 Median $104.71 Typical High $194.98 | Professional | None | $60.26 | $104.71 | $194.98 |
Hometown Health Setting Professional Modifier None Typical Low $66.07 Median $120.23 Typical High $229.09 | Professional | None | $66.07 | $120.23 | $229.09 |
Hometown Health Setting Facility Modifier None Typical Low $109.65 Median $109.65 Typical High $109.65 | Facility | None | $109.65 | $109.65 | $109.65 |
Hometown Health Setting Professional Modifier None Typical Low $1.26 Median $89.13 Typical High $223.87 | Professional | None | $1.26 | $89.13 | $223.87 |
Select Health Setting Facility Modifier None Typical Low $60.26 Median $151.36 Typical High $4,265.80 | Facility | None | $60.26 | $151.36 | $4,265.80 |
Select Health Setting Professional Modifier None Typical Low $63.10 Median $63.10 Typical High $63.10 | Professional | None | $63.10 | $63.10 | $63.10 |
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 $67.61 Median $109.65 Typical High $194.98 | Professional | None | $67.61 | $109.65 | $194.98 |
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 $33.11 Median $50.12 Typical High $74.13 | Professional | 52 · Reduced service | $33.11 | $50.12 | $74.13 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $13.49 Median $20.42 Typical High $30.20 | Professional | 53 · Discontinued | $13.49 | $20.42 | $30.20 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $50.12 Median $75.86 Typical High $112.20 | Professional | 54 · Surgery only | $50.12 | $75.86 | $112.20 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $10.00 Median $15.14 Typical High $22.39 | Professional | 55 · Aftercare only | $10.00 | $15.14 | $22.39 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $6.76 Median $10.00 Typical High $14.79 | Professional | 56 · Pre-op care only | $6.76 | $10.00 | $14.79 |
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· 38th of 51
$126
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.