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 $38.02 Median $41.69 Typical High $67.61 | Facility | None | $38.02 | $41.69 | $67.61 |
Aetna Setting Professional Modifier None Typical Low $38.02 Median $61.66 Typical High $72.44 | Professional | None | $38.02 | $61.66 | $72.44 |
Ambetter Setting Professional Modifier None Typical Low $77.62 Median $77.62 Typical High $77.62 | Professional | None | $77.62 | $77.62 | $77.62 |
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 $38.90 Median $44.67 Typical High $72.44 | Professional | None | $38.90 | $44.67 | $72.44 |
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 $32.36 Median $53.70 Typical High $87.10 | Professional | None | $32.36 | $53.70 | $87.10 |
Hometown Health Setting Professional Modifier None Typical Low $27.54 Median $48.98 Typical High $102.33 | Professional | None | $27.54 | $48.98 | $102.33 |
Hometown Health Setting Professional Modifier None Typical Low $0.30 Median $60.26 Typical High $117.49 | Professional | None | $0.30 | $60.26 | $117.49 |
Select Health Setting Facility Modifier None Typical Low $40.74 Median $79.43 Typical High $4,265.80 | Facility | None | $40.74 | $79.43 | $4,265.80 |
Select Health Setting Professional Modifier None Typical Low $32.36 Median $60.26 Typical High $74.13 | Professional | None | $32.36 | $60.26 | $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 $35.48 Median $56.23 Typical High $91.20 | Professional | None | $35.48 | $56.23 | $91.20 |
4 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 $19.05 Median $30.20 Typical High $33.11 | Professional | 52 · Reduced service | $19.05 | $30.20 | $33.11 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $7.59 Median $12.02 Typical High $13.18 | Professional | 53 · Discontinued | $7.59 | $12.02 | $13.18 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $5.75 Median $9.12 Typical High $10.00 | Professional | 55 · Aftercare only | $5.75 | $9.12 | $10.00 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $3.80 Median $6.03 Typical High $6.61 | Professional | 56 · Pre-op care only | $3.80 | $6.03 | $6.61 |
Where Nevada sits
The same service costs 4.0 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· 48th of 51
$53.70
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.