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 $134.90 Median $1,698.24 Typical High $4,365.16 | Facility | None | $134.90 | $1,698.24 | $4,365.16 |
Aetna Setting Professional Modifier None Typical Low $50.12 Median $100.00 Typical High $134.90 | Professional | None | $50.12 | $100.00 | $134.90 |
Anthem BCBS Setting Facility Modifier None Typical Low $1,096.48 Median $3,548.13 Typical High $4,466.84 | Facility | None | $1,096.48 | $3,548.13 | $4,466.84 |
Anthem BCBS Setting Professional Modifier None Typical Low $46.77 Median $117.49 Typical High $186.21 | Professional | None | $46.77 | $117.49 | $186.21 |
Cigna Setting Facility Modifier None Typical Low $123.03 Median $154.88 Typical High $549.54 | Facility | None | $123.03 | $154.88 | $549.54 |
Cigna Setting Professional Modifier None Typical Low $44.67 Median $66.07 Typical High $147.91 | Professional | None | $44.67 | $66.07 | $147.91 |
Hometown Health Setting Professional Modifier None Typical Low $43.65 Median $102.33 Typical High $177.83 | Professional | None | $43.65 | $102.33 | $177.83 |
Hometown Health Setting Facility Modifier None Typical Low $123.03 Median $123.03 Typical High $123.03 | Facility | None | $123.03 | $123.03 | $123.03 |
Hometown Health Setting Professional Modifier None Typical Low $0.42 Median $66.07 Typical High $223.87 | Professional | None | $0.42 | $66.07 | $223.87 |
Select Health Setting Facility Modifier None Typical Low $44.67 Median $147.91 Typical High $4,265.80 | Facility | None | $44.67 | $147.91 | $4,265.80 |
Select Health Setting Professional Modifier None Typical Low $38.02 Median $54.95 Typical High $147.91 | Professional | None | $38.02 | $54.95 | $147.91 |
United Setting Facility Modifier None Typical Low $302.00 Median $512.86 Typical High $2,137.96 | Facility | None | $302.00 | $512.86 | $2,137.96 |
United Setting Professional Modifier None Typical Low $44.67 Median $89.13 Typical High $162.18 | Professional | None | $44.67 | $89.13 | $162.18 |
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 $25.12 Median $48.98 Typical High $67.61 | Professional | 52 · Reduced service | $25.12 | $48.98 | $67.61 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $10.00 Median $19.50 Typical High $26.92 | Professional | 53 · Discontinued | $10.00 | $19.50 | $26.92 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $37.15 Median $72.44 Typical High $102.33 | Professional | 54 · Surgery only | $37.15 | $72.44 | $102.33 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $7.41 Median $14.79 Typical High $20.42 | Professional | 55 · Aftercare only | $7.41 | $14.79 | $20.42 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $5.01 Median $9.77 Typical High $13.49 | Professional | 56 · Pre-op care only | $5.01 | $9.77 | $13.49 |
Ambetter Setting Professional Modifier 59 · Distinct service Typical Low $40.74 Median $40.74 Typical High $40.74 | Professional | 59 · Distinct service | $40.74 | $40.74 | $40.74 |
Where Nevada sits
The same service costs 3.5 times more in Alaska than in Washington, DC. 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· 37th 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.