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 $42.66 Median $1,698.24 Typical High $4,365.16 | Facility | None | $42.66 | $1,698.24 | $4,365.16 |
Aetna Setting Professional Modifier None Typical Low $42.66 Median $75.86 Typical High $128.82 | Professional | None | $42.66 | $75.86 | $128.82 |
Ambetter Setting Professional Modifier None Typical Low $117.49 Median $117.49 Typical High $173.78 | Professional | None | $117.49 | $117.49 | $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 $39.81 Median $104.71 Typical High $169.82 | Professional | None | $39.81 | $104.71 | $169.82 |
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 $33.88 Median $51.29 Typical High $128.82 | Professional | None | $33.88 | $51.29 | $128.82 |
Hometown Health Setting Professional Modifier None Typical Low $33.11 Median $72.44 Typical High $154.88 | Professional | None | $33.11 | $72.44 | $154.88 |
Hometown Health Setting Professional Modifier None Typical Low $0.42 Median $60.26 Typical High $194.98 | Professional | None | $0.42 | $60.26 | $194.98 |
Select Health Setting Facility Modifier None Typical Low $39.81 Median $128.82 Typical High $4,265.80 | Facility | None | $39.81 | $128.82 | $4,265.80 |
Select Health Setting Professional Modifier None Typical Low $33.88 Median $46.77 Typical High $114.82 | Professional | None | $33.88 | $46.77 | $114.82 |
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 $28.84 Median $75.86 Typical High $141.25 | Professional | None | $28.84 | $75.86 | $141.25 |
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 $21.38 Median $35.48 Typical High $64.57 | Professional | 52 · Reduced service | $21.38 | $35.48 | $64.57 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $8.51 Median $14.13 Typical High $25.70 | Professional | 53 · Discontinued | $8.51 | $14.13 | $25.70 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $32.36 Median $53.70 Typical High $95.50 | Professional | 54 · Surgery only | $32.36 | $53.70 | $95.50 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $6.46 Median $10.72 Typical High $19.05 | Professional | 55 · Aftercare only | $6.46 | $10.72 | $19.05 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $4.27 Median $7.08 Typical High $12.88 | Professional | 56 · Pre-op care only | $4.27 | $7.08 | $12.88 |
Where Nevada sits
The same service costs 3.4 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· 47th of 51
$72.44
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.