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 $112.20 Median $1,698.24 Typical High $4,365.16 | Facility | None | $112.20 | $1,698.24 | $4,365.16 |
Aetna Setting Professional Modifier None Typical Low $93.33 Median $114.82 Typical High $154.88 | Professional | None | $93.33 | $114.82 | $154.88 |
Ambetter Setting Professional Modifier None Typical Low $114.82 Median $114.82 Typical High $138.04 | Professional | None | $114.82 | $114.82 | $138.04 |
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 $89.13 Median $104.71 Typical High $147.91 | Professional | None | $89.13 | $104.71 | $147.91 |
Cigna Setting Facility Modifier None Typical Low $67.61 Median $83.18 Typical High $549.54 | Facility | None | $67.61 | $83.18 | $549.54 |
Cigna Setting Professional Modifier None Typical Low $85.11 Median $169.82 Typical High $371.54 | Professional | None | $85.11 | $169.82 | $371.54 |
Hometown Health Setting Professional Modifier None Typical Low $74.13 Median $109.65 Typical High $186.21 | Professional | None | $74.13 | $109.65 | $186.21 |
Hometown Health Setting Facility Modifier None Typical Low $67.61 Median $67.61 Typical High $67.61 | Facility | None | $67.61 | $67.61 | $67.61 |
Hometown Health Setting Professional Modifier None Typical Low $4.57 Median $100.00 Typical High $169.82 | Professional | None | $4.57 | $100.00 | $169.82 |
Select Health Setting Facility Modifier None Typical Low $74.13 Median $114.82 Typical High $4,265.80 | Facility | None | $74.13 | $114.82 | $4,265.80 |
Select Health Setting Professional Modifier None Typical Low $70.79 Median $114.82 Typical High $158.49 | Professional | None | $70.79 | $114.82 | $158.49 |
United Setting Facility Modifier None Typical Low $97.72 Median $234.42 Typical High $1,949.84 | Facility | None | $97.72 | $234.42 | $1,949.84 |
United Setting Professional Modifier None Typical Low $97.72 Median $154.88 Typical High $234.42 | Professional | None | $97.72 | $154.88 | $234.42 |
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 $46.77 Median $57.54 Typical High $69.18 | Professional | 52 · Reduced service | $46.77 | $57.54 | $69.18 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $18.62 Median $22.91 Typical High $27.54 | Professional | 53 · Discontinued | $18.62 | $22.91 | $27.54 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $69.18 Median $87.10 Typical High $102.33 | Professional | 54 · Surgery only | $69.18 | $87.10 | $102.33 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $14.13 Median $17.38 Typical High $20.89 | Professional | 55 · Aftercare only | $14.13 | $17.38 | $20.89 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $9.33 Median $11.48 Typical High $13.80 | Professional | 56 · Pre-op care only | $9.33 | $11.48 | $13.80 |
Where Nevada sits
The same service costs 3.7 times more in Alaska 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· 39th of 51
$126
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.