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 $208.93 Median $1,698.24 Typical High $4,466.84 | Facility | None | $208.93 | $1,698.24 | $4,466.84 |
Aetna Setting Professional Modifier None Typical Low $208.93 Median $208.93 Typical High $316.23 | Professional | None | $208.93 | $208.93 | $316.23 |
Anthem BCBS Setting Facility Modifier None Typical Low $2,951.21 Median $4,677.35 Typical High $6,165.95 | Facility | None | $2,951.21 | $4,677.35 | $6,165.95 |
Anthem BCBS Setting Professional Modifier None Typical Low $169.82 Median $223.87 Typical High $323.59 | Professional | None | $169.82 | $223.87 | $323.59 |
Cigna Setting Facility Modifier None Typical Low $691.83 Median $1,621.81 Typical High $2,238.72 | Facility | None | $691.83 | $1,621.81 | $2,238.72 |
Hometown Health Setting Facility Modifier None Typical Low $1,548.82 Median $1,548.82 Typical High $1,548.82 | Facility | None | $1,548.82 | $1,548.82 | $1,548.82 |
Select Health Setting Facility Modifier None Typical Low $114.82 Median $245.47 Typical High $4,265.80 | Facility | None | $114.82 | $245.47 | $4,265.80 |
Select Health Setting Professional Modifier None Typical Low $223.87 Median $223.87 Typical High $223.87 | Professional | None | $223.87 | $223.87 | $223.87 |
United Setting Facility Modifier None Typical Low $1,621.81 Median $2,398.83 Typical High $6,918.31 | Facility | None | $1,621.81 | $2,398.83 | $6,918.31 |
United Setting Professional Modifier None Typical Low $204.17 Median $245.47 Typical High $398.11 | Professional | None | $204.17 | $245.47 | $398.11 |
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 $104.71 Median $104.71 Typical High $104.71 | Professional | 52 · Reduced service | $104.71 | $104.71 | $104.71 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $41.69 Median $41.69 Typical High $41.69 | Professional | 53 · Discontinued | $41.69 | $41.69 | $41.69 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $158.49 Median $158.49 Typical High $158.49 | Professional | 54 · Surgery only | $158.49 | $158.49 | $158.49 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $31.62 Median $31.62 Typical High $31.62 | Professional | 55 · Aftercare only | $31.62 | $31.62 | $31.62 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $20.89 Median $20.89 Typical High $20.89 | Professional | 56 · Pre-op care only | $20.89 | $20.89 | $20.89 |
Where Nevada sits
The same service costs 19.5 times more in Texas than in New York. 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
$316
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.