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 $61.66 Median $1,698.24 Typical High $4,365.16 | Facility | None | $61.66 | $1,698.24 | $4,365.16 |
Aetna Setting Professional Modifier None Typical Low $43.65 Median $61.66 Typical High $79.43 | Professional | None | $43.65 | $61.66 | $79.43 |
Ambetter Setting Professional Modifier None Typical Low $32.36 Median $64.57 Typical High $87.10 | Professional | None | $32.36 | $64.57 | $87.10 |
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 $44.67 Median $64.57 Typical High $107.15 | Professional | None | $44.67 | $64.57 | $107.15 |
Cigna Setting Facility Modifier None Typical Low $40.74 Median $58.88 Typical High $17,782.79 | Facility | None | $40.74 | $58.88 | $17,782.79 |
Cigna Setting Professional Modifier None Typical Low $41.69 Median $58.88 Typical High $102.33 | Professional | None | $41.69 | $58.88 | $102.33 |
Hometown Health Setting Professional Modifier None Typical Low $30.90 Median $50.12 Typical High $89.13 | Professional | None | $30.90 | $50.12 | $89.13 |
Hometown Health Setting Facility Modifier None Typical Low $40.74 Median $40.74 Typical High $40.74 | Facility | None | $40.74 | $40.74 | $40.74 |
Hometown Health Setting Professional Modifier None Typical Low $0.36 Median $58.88 Typical High $102.33 | Professional | None | $0.36 | $58.88 | $102.33 |
Select Health Setting Facility Modifier None Typical Low $38.90 Median $67.61 Typical High $4,265.80 | Facility | None | $38.90 | $67.61 | $4,265.80 |
Select Health Setting Professional Modifier None Typical Low $30.90 Median $61.66 Typical High $309.03 | Professional | None | $30.90 | $61.66 | $309.03 |
United Setting Facility Modifier None Typical Low $97.72 Median $245.47 Typical High $1,995.26 | Facility | None | $97.72 | $245.47 | $1,995.26 |
United Setting Professional Modifier None Typical Low $38.02 Median $61.66 Typical High $97.72 | Professional | None | $38.02 | $61.66 | $97.72 |
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 $21.88 Median $29.51 Typical High $33.88 | Professional | 52 · Reduced service | $21.88 | $29.51 | $33.88 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $8.71 Median $11.75 Typical High $13.49 | Professional | 53 · Discontinued | $8.71 | $11.75 | $13.49 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $32.36 Median $43.65 Typical High $50.12 | Professional | 54 · Surgery only | $32.36 | $43.65 | $50.12 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $6.46 Median $8.91 Typical High $10.00 | Professional | 55 · Aftercare only | $6.46 | $8.91 | $10.00 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $4.37 Median $5.89 Typical High $6.76 | Professional | 56 · Pre-op care only | $4.37 | $5.89 | $6.76 |
Where Nevada sits
The same service costs 4.2 times more in Alaska than in Florida. 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· 48th of 51
$61.66
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.