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 $15.49 Median $1,698.24 Typical High $4,466.84 | Facility | None | $15.49 | $1,698.24 | $4,466.84 |
Aetna Setting Professional Modifier None Typical Low $14.79 Median $14.79 Typical High $33.11 | Professional | None | $14.79 | $14.79 | $33.11 |
Ambetter Setting Professional Modifier None Typical Low $18.20 Median $30.90 Typical High $43.65 | Professional | None | $18.20 | $30.90 | $43.65 |
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 $15.14 Median $18.20 Typical High $26.92 | Professional | None | $15.14 | $18.20 | $26.92 |
Cigna Setting Facility Modifier None Typical Low $66.07 Median $741.31 Typical High $2,089.30 | Facility | None | $66.07 | $741.31 | $2,089.30 |
Cigna Setting Professional Modifier None Typical Low $10.47 Median $11.22 Typical High $20.89 | Professional | None | $10.47 | $11.22 | $20.89 |
Hometown Health Setting Professional Modifier None Typical Low $0.21 Median $14.13 Typical High $28.84 | Professional | None | $0.21 | $14.13 | $28.84 |
Hometown Health Setting Professional Modifier None Typical Low $0.18 Median $0.18 Typical High $25.70 | Professional | None | $0.18 | $0.18 | $25.70 |
Select Health Setting Facility Modifier None Typical Low $16.98 Median $16.98 Typical High $4,265.80 | Facility | None | $16.98 | $16.98 | $4,265.80 |
Select Health Setting Professional Modifier None Typical Low $15.14 Median $15.14 Typical High $15.14 | Professional | None | $15.14 | $15.14 | $15.14 |
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 $11.48 Median $15.85 Typical High $23.99 | Professional | None | $11.48 | $15.85 | $23.99 |
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 $7.41 Median $7.41 Typical High $7.76 | Professional | 52 · Reduced service | $7.41 | $7.41 | $7.76 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $2.95 Median $2.95 Typical High $3.09 | Professional | 53 · Discontinued | $2.95 | $2.95 | $3.09 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $11.22 Median $11.22 Typical High $11.48 | Professional | 54 · Surgery only | $11.22 | $11.22 | $11.48 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $2.24 Median $2.24 Typical High $2.29 | Professional | 55 · Aftercare only | $2.24 | $2.24 | $2.29 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $1.48 Median $1.48 Typical High $1.55 | Professional | 56 · Pre-op care only | $1.48 | $1.48 | $1.55 |
Where Nevada sits
The same service costs 7.4 times more in Kansas than in Kentucky. 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· 48th of 51
$18.20
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.