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 $117.49 Median $1,698.24 Typical High $4,365.16 | Facility | None | $117.49 | $1,698.24 | $4,365.16 |
Aetna Setting Professional Modifier None Typical Low $117.49 Median $147.91 Typical High $177.83 | Professional | None | $117.49 | $147.91 | $177.83 |
Ambetter Setting Professional Modifier None Typical Low $173.78 Median $173.78 Typical High $173.78 | Professional | None | $173.78 | $173.78 | $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 $114.82 Median $131.83 Typical High $213.80 | Professional | None | $114.82 | $131.83 | $213.80 |
Cigna Setting Facility Modifier None Typical Low $117.49 Median $151.36 Typical High $912.01 | Facility | None | $117.49 | $151.36 | $912.01 |
Cigna Setting Professional Modifier None Typical Low $95.50 Median $138.04 Typical High $223.87 | Professional | None | $95.50 | $138.04 | $223.87 |
Hometown Health Setting Professional Modifier None Typical Low $79.43 Median $128.82 Typical High $245.47 | Professional | None | $79.43 | $128.82 | $245.47 |
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 $1.70 Median $151.36 Typical High $281.84 | Professional | None | $1.70 | $151.36 | $281.84 |
Select Health Setting Facility Modifier None Typical Low $102.33 Median $190.55 Typical High $4,265.80 | Facility | None | $102.33 | $190.55 | $4,265.80 |
Select Health Setting Professional Modifier None Typical Low $81.28 Median $151.36 Typical High $177.83 | Professional | None | $81.28 | $151.36 | $177.83 |
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 $117.49 Median $165.96 Typical High $245.47 | Professional | None | $117.49 | $165.96 | $245.47 |
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 $58.88 Median $77.62 Typical High $89.13 | Professional | 52 · Reduced service | $58.88 | $77.62 | $89.13 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $23.44 Median $30.90 Typical High $36.31 | Professional | 53 · Discontinued | $23.44 | $30.90 | $36.31 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $89.13 Median $117.49 Typical High $134.90 | Professional | 54 · Surgery only | $89.13 | $117.49 | $134.90 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $17.78 Median $23.44 Typical High $26.92 | Professional | 55 · Aftercare only | $17.78 | $23.44 | $26.92 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $11.75 Median $15.49 Typical High $17.78 | Professional | 56 · Pre-op care only | $11.75 | $15.49 | $17.78 |
Where Nevada sits
The same service costs 3.3 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· 45th of 51
$155
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.