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 $63.10 Median $1,698.24 Typical High $4,365.16 | Facility | None | $63.10 | $1,698.24 | $4,365.16 |
Aetna Setting Professional Modifier None Typical Low $60.26 Median $93.33 Typical High $173.78 | Professional | None | $60.26 | $93.33 | $173.78 |
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 $54.95 Median $67.61 Typical High $120.23 | Professional | None | $54.95 | $67.61 | $120.23 |
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 $47.86 Median $81.28 Typical High $177.83 | Professional | None | $47.86 | $81.28 | $177.83 |
Hometown Health Setting Professional Modifier None Typical Low $50.12 Median $85.11 Typical High $263.03 | Professional | None | $50.12 | $85.11 | $263.03 |
Hometown Health Setting Professional Modifier None Typical Low $0.60 Median $72.44 Typical High $245.47 | Professional | None | $0.60 | $72.44 | $245.47 |
Select Health Setting Facility Modifier None Typical Low $48.98 Median $165.96 Typical High $4,265.80 | Facility | None | $48.98 | $165.96 | $4,265.80 |
Select Health Setting Professional Modifier None Typical Low $147.91 Median $147.91 Typical High $147.91 | Professional | None | $147.91 | $147.91 | $147.91 |
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 $57.54 Median $109.65 Typical High $213.80 | Professional | None | $57.54 | $109.65 | $213.80 |
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 $30.20 Median $44.67 Typical High $87.10 | Professional | 52 · Reduced service | $30.20 | $44.67 | $87.10 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $12.02 Median $17.78 Typical High $35.48 | Professional | 53 · Discontinued | $12.02 | $17.78 | $35.48 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $45.71 Median $67.61 Typical High $131.83 | Professional | 54 · Surgery only | $45.71 | $67.61 | $131.83 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $9.12 Median $13.49 Typical High $26.30 | Professional | 55 · Aftercare only | $9.12 | $13.49 | $26.30 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $6.03 Median $8.91 Typical High $17.38 | Professional | 56 · Pre-op care only | $6.03 | $8.91 | $17.38 |
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· 47th of 51
$97.72
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.