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 $89.13 Median $1,659.59 Typical High $4,365.16 | Facility | None | $89.13 | $1,659.59 | $4,365.16 |
Aetna Setting Professional Modifier None Typical Low $44.67 Median $89.13 Typical High $109.65 | Professional | None | $44.67 | $89.13 | $109.65 |
Ambetter Setting Professional Modifier None Typical Low $23.99 Median $23.99 Typical High $83.18 | Professional | None | $23.99 | $23.99 | $83.18 |
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 $42.66 Median $87.10 Typical High $131.83 | Professional | None | $42.66 | $87.10 | $131.83 |
Cigna Setting Facility Modifier None Typical Low $63.10 Median $63.10 Typical High $63.10 | Facility | None | $63.10 | $63.10 | $63.10 |
Cigna Setting Professional Modifier None Typical Low $57.54 Median $93.33 Typical High $158.49 | Professional | None | $57.54 | $93.33 | $158.49 |
Hometown Health Setting Professional Modifier None Typical Low $44.67 Median $83.18 Typical High $117.49 | Professional | None | $44.67 | $83.18 | $117.49 |
Hometown Health Setting Professional Modifier None Typical Low $0.48 Median $56.23 Typical High $138.04 | Professional | None | $0.48 | $56.23 | $138.04 |
Select Health Setting Facility Modifier None Typical Low $37.15 Median $91.20 Typical High $4,265.80 | Facility | None | $37.15 | $91.20 | $4,265.80 |
Select Health Setting Professional Modifier None Typical Low $31.62 Median $50.12 Typical High $91.20 | Professional | None | $31.62 | $50.12 | $91.20 |
United Setting Facility Modifier None Typical Low $251.19 Median $1,412.54 Typical High $2,041.74 | Facility | None | $251.19 | $1,412.54 | $2,041.74 |
United Setting Professional Modifier None Typical Low $43.65 Median $87.10 Typical High $138.04 | Professional | None | $43.65 | $87.10 | $138.04 |
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 $22.39 Median $42.66 Typical High $45.71 | Professional | 52 · Reduced service | $22.39 | $42.66 | $45.71 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $8.91 Median $16.98 Typical High $18.62 | Professional | 53 · Discontinued | $8.91 | $16.98 | $18.62 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $33.11 Median $64.57 Typical High $69.18 | Professional | 54 · Surgery only | $33.11 | $64.57 | $69.18 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $6.61 Median $12.88 Typical High $13.80 | Professional | 55 · Aftercare only | $6.61 | $12.88 | $13.80 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $4.47 Median $8.51 Typical High $9.33 | Professional | 56 · Pre-op care only | $4.47 | $8.51 | $9.33 |
Where Nevada sits
The same service costs 2.5 times more in North Carolina 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· 36th of 51
$87.10
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.