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 $43.65 Median $1,698.24 Typical High $4,365.16 | Facility | None | $43.65 | $1,698.24 | $4,365.16 |
Aetna Setting Professional Modifier None Typical Low $38.90 Median $56.23 Typical High $67.61 | Professional | None | $38.90 | $56.23 | $67.61 |
Ambetter Setting Professional Modifier None Typical Low $64.57 Median $64.57 Typical High $154.88 | Professional | None | $64.57 | $64.57 | $154.88 |
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 $40.74 Median $63.10 Typical High $100.00 | Professional | None | $40.74 | $63.10 | $100.00 |
Cigna Setting Facility Modifier None Typical Low $44.67 Median $54.95 Typical High $549.54 | Facility | None | $44.67 | $54.95 | $549.54 |
Cigna Setting Professional Modifier None Typical Low $34.67 Median $48.98 Typical High $81.28 | Professional | None | $34.67 | $48.98 | $81.28 |
Hometown Health Setting Professional Modifier None Typical Low $28.18 Median $46.77 Typical High $85.11 | Professional | None | $28.18 | $46.77 | $85.11 |
Hometown Health Setting Facility Modifier None Typical Low $44.67 Median $44.67 Typical High $44.67 | Facility | None | $44.67 | $44.67 | $44.67 |
Hometown Health Setting Professional Modifier None Typical Low $0.36 Median $54.95 Typical High $100.00 | Professional | None | $0.36 | $54.95 | $100.00 |
Select Health Setting Facility Modifier None Typical Low $36.31 Median $67.61 Typical High $4,265.80 | Facility | None | $36.31 | $67.61 | $4,265.80 |
Select Health Setting Professional Modifier None Typical Low $28.84 Median $53.70 Typical High $74.13 | Professional | None | $28.84 | $53.70 | $74.13 |
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 $38.90 Median $54.95 Typical High $85.11 | Professional | None | $38.90 | $54.95 | $85.11 |
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 $19.50 Median $29.51 Typical High $30.90 | Professional | 52 · Reduced service | $19.50 | $29.51 | $30.90 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $7.94 Median $11.75 Typical High $12.30 | Professional | 53 · Discontinued | $7.94 | $11.75 | $12.30 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $29.51 Median $44.67 Typical High $46.77 | Professional | 54 · Surgery only | $29.51 | $44.67 | $46.77 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $5.89 Median $8.91 Typical High $9.33 | Professional | 55 · Aftercare only | $5.89 | $8.91 | $9.33 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $3.89 Median $5.89 Typical High $6.17 | Professional | 56 · Pre-op care only | $3.89 | $5.89 | $6.17 |
Where Nevada sits
The same service costs 3.5 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· 43rd of 51
$58.88
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.