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 $95.50 Median $1,698.24 Typical High $4,365.16 | Facility | None | $95.50 | $1,698.24 | $4,365.16 |
Aetna Setting Professional Modifier None Typical Low $56.23 Median $89.13 Typical High $104.71 | Professional | None | $56.23 | $89.13 | $104.71 |
Ambetter Setting Professional Modifier None Typical Low $83.18 Median $97.72 Typical High $102.33 | Professional | None | $83.18 | $97.72 | $102.33 |
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 $57.54 Median $97.72 Typical High $154.88 | Professional | None | $57.54 | $97.72 | $154.88 |
Cigna Setting Facility Modifier None Typical Low $63.10 Median $81.28 Typical High $912.01 | Facility | None | $63.10 | $81.28 | $912.01 |
Cigna Setting Professional Modifier None Typical Low $50.12 Median $79.43 Typical High $123.03 | Professional | None | $50.12 | $79.43 | $123.03 |
Hometown Health Setting Professional Modifier None Typical Low $41.69 Median $67.61 Typical High $128.82 | Professional | None | $41.69 | $67.61 | $128.82 |
Hometown Health Setting Facility Modifier None Typical Low $67.61 Median $67.61 Typical High $67.61 | Facility | None | $67.61 | $67.61 | $67.61 |
Hometown Health Setting Professional Modifier None Typical Low $0.60 Median $74.13 Typical High $154.88 | Professional | None | $0.60 | $74.13 | $154.88 |
Select Health Setting Facility Modifier None Typical Low $48.98 Median $102.33 Typical High $4,265.80 | Facility | None | $48.98 | $102.33 | $4,265.80 |
Select Health Setting Professional Modifier None Typical Low $39.81 Median $83.18 Typical High $102.33 | Professional | None | $39.81 | $83.18 | $102.33 |
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 $61.66 Median $91.20 Typical High $141.25 | Professional | None | $61.66 | $91.20 | $141.25 |
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 $28.18 Median $44.67 Typical High $47.86 | Professional | 52 · Reduced service | $28.18 | $44.67 | $47.86 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $11.22 Median $17.78 Typical High $19.05 | Professional | 53 · Discontinued | $11.22 | $17.78 | $19.05 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $42.66 Median $67.61 Typical High $74.13 | Professional | 54 · Surgery only | $42.66 | $67.61 | $74.13 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $8.51 Median $13.49 Typical High $14.45 | Professional | 55 · Aftercare only | $8.51 | $13.49 | $14.45 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $5.62 Median $8.91 Typical High $9.55 | Professional | 56 · Pre-op care only | $5.62 | $8.91 | $9.55 |
Ambetter Setting Professional Modifier 50 · Both sides Typical Low $125.89 Median $125.89 Typical High $147.91 | Professional | 50 · Both sides | $125.89 | $125.89 | $147.91 |
Where Nevada sits
The same service costs 3.7 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· 40th of 51
$93.33
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.