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 $74.13 Median $1,698.24 Typical High $4,365.16 | Facility | None | $74.13 | $1,698.24 | $4,365.16 |
Aetna Setting Professional Modifier None Typical Low $41.69 Median $74.13 Typical High $97.72 | Professional | None | $41.69 | $74.13 | $97.72 |
Ambetter Setting Professional Modifier None Typical Low $81.28 Median $81.28 Typical High $95.50 | Professional | None | $81.28 | $81.28 | $95.50 |
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 $41.69 Median $47.86 Typical High $77.62 | Professional | None | $41.69 | $47.86 | $77.62 |
Cigna Setting Facility Modifier None Typical Low $56.23 Median $70.79 Typical High $549.54 | Facility | None | $56.23 | $70.79 | $549.54 |
Cigna Setting Professional Modifier None Typical Low $47.86 Median $85.11 Typical High $125.89 | Professional | None | $47.86 | $85.11 | $125.89 |
Hometown Health Setting Professional Modifier None Typical Low $47.86 Median $67.61 Typical High $125.89 | Professional | None | $47.86 | $67.61 | $125.89 |
Hometown Health Setting Facility Modifier None Typical Low $56.23 Median $56.23 Typical High $56.23 | Facility | None | $56.23 | $56.23 | $56.23 |
Hometown Health Setting Professional Modifier None Typical Low $0.36 Median $57.54 Typical High $120.23 | Professional | None | $0.36 | $57.54 | $120.23 |
Select Health Setting Facility Modifier None Typical Low $38.02 Median $81.28 Typical High $4,265.80 | Facility | None | $38.02 | $81.28 | $4,265.80 |
Select Health Setting Professional Modifier None Typical Low $30.20 Median $72.44 Typical High $512.86 | Professional | None | $30.20 | $72.44 | $512.86 |
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 $45.71 Median $77.62 Typical High $134.90 | Professional | None | $45.71 | $77.62 | $134.90 |
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 $20.89 Median $32.36 Typical High $38.02 | Professional | 52 · Reduced service | $20.89 | $32.36 | $38.02 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $8.32 Median $13.18 Typical High $15.14 | Professional | 53 · Discontinued | $8.32 | $13.18 | $15.14 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $31.62 Median $48.98 Typical High $56.23 | Professional | 54 · Surgery only | $31.62 | $48.98 | $56.23 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $6.31 Median $9.77 Typical High $11.22 | Professional | 55 · Aftercare only | $6.31 | $9.77 | $11.22 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $4.17 Median $6.61 Typical High $7.59 | Professional | 56 · Pre-op care only | $4.17 | $6.61 | $7.59 |
Where Nevada sits
The same service costs 3.5 times more in Alaska than in Virginia. 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· 42nd of 51
$75.86
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.