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 $28.18 Median $1,698.24 Typical High $4,365.16 | Facility | None | $28.18 | $1,698.24 | $4,365.16 |
Aetna Setting Professional Modifier None Typical Low $26.92 Median $47.86 Typical High $72.44 | Professional | None | $26.92 | $47.86 | $72.44 |
Ambetter Setting Professional Modifier None Typical Low $43.65 Median $51.29 Typical High $57.54 | Professional | None | $43.65 | $51.29 | $57.54 |
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 $28.84 Median $54.95 Typical High $83.18 | Professional | None | $28.84 | $54.95 | $83.18 |
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 $26.30 Median $46.77 Typical High $70.79 | Professional | None | $26.30 | $46.77 | $70.79 |
Hometown Health Setting Professional Modifier None Typical Low $26.30 Median $44.67 Typical High $85.11 | Professional | None | $26.30 | $44.67 | $85.11 |
Hometown Health Setting Professional Modifier None Typical Low $0.30 Median $35.48 Typical High $85.11 | Professional | None | $0.30 | $35.48 | $85.11 |
Select Health Setting Facility Modifier None Typical Low $23.99 Median $56.23 Typical High $4,265.80 | Facility | None | $23.99 | $56.23 | $4,265.80 |
Select Health Setting Professional Modifier None Typical Low $25.12 Median $25.12 Typical High $25.12 | Professional | None | $25.12 | $25.12 | $25.12 |
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 $24.55 Median $47.86 Typical High $74.13 | Professional | None | $24.55 | $47.86 | $74.13 |
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 $13.49 Median $22.91 Typical High $26.92 | Professional | 52 · Reduced service | $13.49 | $22.91 | $26.92 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $5.37 Median $9.12 Typical High $10.72 | Professional | 53 · Discontinued | $5.37 | $9.12 | $10.72 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $19.95 Median $33.88 Typical High $40.74 | Professional | 54 · Surgery only | $19.95 | $33.88 | $40.74 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $3.98 Median $6.76 Typical High $8.13 | Professional | 55 · Aftercare only | $3.98 | $6.76 | $8.13 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $2.69 Median $4.57 Typical High $5.37 | Professional | 56 · Pre-op care only | $2.69 | $4.57 | $5.37 |
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· 36th of 51
$52.48
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.