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 $24.55 Median $1,698.24 Typical High $4,365.16 | Facility | None | $24.55 | $1,698.24 | $4,365.16 |
Aetna Setting Professional Modifier None Typical Low $21.88 Median $35.48 Typical High $53.70 | Professional | None | $21.88 | $35.48 | $53.70 |
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 $23.44 Median $42.66 Typical High $64.57 | Professional | None | $23.44 | $42.66 | $64.57 |
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 $20.89 Median $36.31 Typical High $56.23 | Professional | None | $20.89 | $36.31 | $56.23 |
Hometown Health Setting Professional Modifier None Typical Low $23.44 Median $37.15 Typical High $67.61 | Professional | None | $23.44 | $37.15 | $67.61 |
Hometown Health Setting Professional Modifier None Typical Low $0.54 Median $31.62 Typical High $67.61 | Professional | None | $0.54 | $31.62 | $67.61 |
Select Health Setting Facility Modifier None Typical Low $20.89 Median $44.67 Typical High $4,265.80 | Facility | None | $20.89 | $44.67 | $4,265.80 |
Select Health Setting Professional Modifier None Typical Low $22.39 Median $22.39 Typical High $22.39 | Professional | None | $22.39 | $22.39 | $22.39 |
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 $25.12 Median $41.69 Typical High $58.88 | Professional | None | $25.12 | $41.69 | $58.88 |
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 $12.02 Median $17.38 Typical High $22.91 | Professional | 52 · Reduced service | $12.02 | $17.38 | $22.91 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $4.79 Median $6.92 Typical High $9.12 | Professional | 53 · Discontinued | $4.79 | $6.92 | $9.12 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $18.20 Median $25.70 Typical High $33.88 | Professional | 54 · Surgery only | $18.20 | $25.70 | $33.88 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $3.63 Median $5.13 Typical High $6.92 | Professional | 55 · Aftercare only | $3.63 | $5.13 | $6.92 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $2.40 Median $3.47 Typical High $4.57 | Professional | 56 · Pre-op care only | $2.40 | $3.47 | $4.57 |
Ambetter Setting Professional Modifier 59 · Distinct service Typical Low $40.74 Median $40.74 Typical High $40.74 | Professional | 59 · Distinct service | $40.74 | $40.74 | $40.74 |
Where Nevada sits
The same service costs 3.5 times more in Alaska than in New Jersey. 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· 30th of 51
$43.65
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.