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 $213.80 Median $2,570.40 Typical High $6,165.95 | Facility | None | $213.80 | $2,570.40 | $6,165.95 |
Aetna Setting Professional Modifier None Typical Low $213.80 Median $213.80 Typical High $281.84 | Professional | None | $213.80 | $213.80 | $281.84 |
Anthem BCBS Setting Professional Modifier None Typical Low $151.36 Median $257.04 Typical High $316.23 | Professional | None | $151.36 | $257.04 | $316.23 |
Cigna Setting Facility Modifier None Typical Low $562.34 Median $758.58 Typical High $2,137.96 | Facility | None | $562.34 | $758.58 | $2,137.96 |
Select Health Setting Facility Modifier None Typical Low $4,265.80 Median $4,265.80 Typical High $4,265.80 | Facility | None | $4,265.80 | $4,265.80 | $4,265.80 |
Select Health Setting Professional Modifier None Typical Low $5,011.87 Median $5,011.87 Typical High $5,128.61 | Professional | None | $5,011.87 | $5,011.87 | $5,128.61 |
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 $234.42 Median $257.04 Typical High $398.11 | Professional | None | $234.42 | $257.04 | $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 $107.15 Median $107.15 Typical High $114.82 | Professional | 52 · Reduced service | $107.15 | $107.15 | $114.82 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $42.66 Median $42.66 Typical High $45.71 | Professional | 53 · Discontinued | $42.66 | $42.66 | $45.71 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $162.18 Median $162.18 Typical High $169.82 | Professional | 54 · Surgery only | $162.18 | $162.18 | $169.82 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $32.36 Median $32.36 Typical High $33.88 | Professional | 55 · Aftercare only | $32.36 | $32.36 | $33.88 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $21.38 Median $21.38 Typical High $22.91 | Professional | 56 · Pre-op care only | $21.38 | $21.38 | $22.91 |
Where Nevada sits
The same service costs 18.6 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· 24th of 51
$257
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.