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 $63.10 Median $1,698.24 Typical High $4,365.16 | Facility | None | $63.10 | $1,698.24 | $4,365.16 |
Aetna Setting Professional Modifier None Typical Low $60.26 Median $95.50 Typical High $141.25 | Professional | None | $60.26 | $95.50 | $141.25 |
Ambetter Setting Professional Modifier None Typical Low $85.11 Median $100.00 Typical High $131.83 | Professional | None | $85.11 | $100.00 | $131.83 |
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 $64.57 Median $112.20 Typical High $169.82 | Professional | None | $64.57 | $112.20 | $169.82 |
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 $58.88 Median $93.33 Typical High $138.04 | Professional | None | $58.88 | $93.33 | $138.04 |
Hometown Health Setting Professional Modifier None Typical Low $67.61 Median $104.71 Typical High $165.96 | Professional | None | $67.61 | $104.71 | $165.96 |
Hometown Health Setting Professional Modifier None Typical Low $0.48 Median $93.33 Typical High $165.96 | Professional | None | $0.48 | $93.33 | $165.96 |
Select Health Setting Facility Modifier None Typical Low $61.66 Median $112.20 Typical High $4,265.80 | Facility | None | $61.66 | $112.20 | $4,265.80 |
Select Health Setting Professional Modifier None Typical Low $64.57 Median $64.57 Typical High $64.57 | Professional | None | $64.57 | $64.57 | $64.57 |
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 $50.12 Median $89.13 Typical High $144.54 | Professional | None | $50.12 | $89.13 | $144.54 |
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 $30.20 Median $45.71 Typical High $53.70 | Professional | 52 · Reduced service | $30.20 | $45.71 | $53.70 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $12.02 Median $18.20 Typical High $21.88 | Professional | 53 · Discontinued | $12.02 | $18.20 | $21.88 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $45.71 Median $67.61 Typical High $81.28 | Professional | 54 · Surgery only | $45.71 | $67.61 | $81.28 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $9.12 Median $13.80 Typical High $16.22 | Professional | 55 · Aftercare only | $9.12 | $13.80 | $16.22 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $6.03 Median $9.12 Typical High $10.72 | Professional | 56 · Pre-op care only | $6.03 | $9.12 | $10.72 |
Aetna Setting Professional Modifier 78 · Unplanned return to OR Typical Low $42.66 Median $63.10 Typical High $75.86 | Professional | 78 · Unplanned return to OR | $42.66 | $63.10 | $75.86 |
Where Nevada sits
The same service costs 3.9 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
$105
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.