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 $51.29 Median $1,698.24 Typical High $4,365.16 | Facility | None | $51.29 | $1,698.24 | $4,365.16 |
Aetna Setting Professional Modifier None Typical Low $36.31 Median $50.12 Typical High $56.23 | Professional | None | $36.31 | $50.12 | $56.23 |
Ambetter Setting Professional Modifier None Typical Low $48.98 Median $48.98 Typical High $48.98 | Professional | None | $48.98 | $48.98 | $48.98 |
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 $37.15 Median $53.70 Typical High $85.11 | Professional | None | $37.15 | $53.70 | $85.11 |
Cigna Setting Facility Modifier None Typical Low $29.51 Median $37.15 Typical High $549.54 | Facility | None | $29.51 | $37.15 | $549.54 |
Cigna Setting Professional Modifier None Typical Low $30.90 Median $44.67 Typical High $70.79 | Professional | None | $30.90 | $44.67 | $70.79 |
Hometown Health Setting Professional Modifier None Typical Low $25.70 Median $41.69 Typical High $66.07 | Professional | None | $25.70 | $41.69 | $66.07 |
Hometown Health Setting Facility Modifier None Typical Low $29.51 Median $29.51 Typical High $29.51 | Facility | None | $29.51 | $29.51 | $29.51 |
Hometown Health Setting Professional Modifier None Typical Low $0.36 Median $44.67 Typical High $77.62 | Professional | None | $0.36 | $44.67 | $77.62 |
Select Health Setting Facility Modifier None Typical Low $35.48 Median $51.29 Typical High $4,265.80 | Facility | None | $35.48 | $51.29 | $4,265.80 |
Select Health Setting Professional Modifier None Typical Low $28.18 Median $46.77 Typical High $309.03 | Professional | None | $28.18 | $46.77 | $309.03 |
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 $33.88 Median $50.12 Typical High $77.62 | Professional | None | $33.88 | $50.12 | $77.62 |
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 $18.20 Median $23.44 Typical High $27.54 | Professional | 52 · Reduced service | $18.20 | $23.44 | $27.54 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $7.24 Median $9.55 Typical High $10.96 | Professional | 53 · Discontinued | $7.24 | $9.55 | $10.96 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $26.92 Median $35.48 Typical High $40.74 | Professional | 54 · Surgery only | $26.92 | $35.48 | $40.74 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $5.37 Median $7.08 Typical High $8.13 | Professional | 55 · Aftercare only | $5.37 | $7.08 | $8.13 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $3.63 Median $4.68 Typical High $5.50 | Professional | 56 · Pre-op care only | $3.63 | $4.68 | $5.50 |
Where Nevada sits
The same service costs 4.2 times more in Alaska than in New York. 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· 42nd of 51
$51.29
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.