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 $1.91 Median $1,698.24 Typical High $4,365.16 | Facility | None | $1.91 | $1,698.24 | $4,365.16 |
Aetna Setting Professional Modifier None Typical Low $1.82 Median $5.75 Typical High $8.91 | Professional | None | $1.82 | $5.75 | $8.91 |
Ambetter Setting Professional Modifier None Typical Low $5.75 Median $7.59 Typical High $14.45 | Professional | None | $5.75 | $7.59 | $14.45 |
Anthem BCBS Setting Professional Modifier None Typical Low $2.00 Median $5.62 Typical High $10.00 | Professional | None | $2.00 | $5.62 | $10.00 |
Cigna Setting Facility Modifier None Typical Low $660.69 Median $1,122.02 Typical High $2,691.53 | Facility | None | $660.69 | $1,122.02 | $2,691.53 |
Cigna Setting Professional Modifier None Typical Low $2.51 Median $6.03 Typical High $11.22 | Professional | None | $2.51 | $6.03 | $11.22 |
Hometown Health Setting Professional Modifier None Typical Low $1.82 Median $4.79 Typical High $9.77 | Professional | None | $1.82 | $4.79 | $9.77 |
Hometown Health Setting Professional Modifier None Typical Low $0.12 Median $2.51 Typical High $9.55 | Professional | None | $0.12 | $2.51 | $9.55 |
Select Health Setting Facility Modifier None Typical Low $1.66 Median $6.31 Typical High $4,265.80 | Facility | None | $1.66 | $6.31 | $4,265.80 |
Select Health Setting Professional Modifier None Typical Low $1.74 Median $1.74 Typical High $1.74 | Professional | None | $1.74 | $1.74 | $1.74 |
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 $2.14 Median $6.17 Typical High $14.13 | Professional | None | $2.14 | $6.17 | $14.13 |
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 $0.91 Median $2.09 Typical High $3.16 | Professional | 52 · Reduced service | $0.91 | $2.09 | $3.16 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $0.37 Median $0.83 Typical High $1.26 | Professional | 53 · Discontinued | $0.37 | $0.83 | $1.26 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $1.38 Median $3.16 Typical High $4.79 | Professional | 54 · Surgery only | $1.38 | $3.16 | $4.79 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $0.27 Median $0.63 Typical High $0.95 | Professional | 55 · Aftercare only | $0.27 | $0.63 | $0.95 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $0.18 Median $0.49 Typical High $0.65 | Professional | 56 · Pre-op care only | $0.18 | $0.49 | $0.65 |
Ambetter Setting Professional Modifier 59 · Distinct service Typical Low $4.90 Median $6.31 Typical High $8.91 | Professional | 59 · Distinct service | $4.90 | $6.31 | $8.91 |
Where Nevada sits
The same service costs 3.0 times more in Alaska than in Nebraska. 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
$6.17
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.