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 $69.18 Median $1,698.24 Typical High $4,365.16 | Facility | None | $69.18 | $1,698.24 | $4,365.16 |
Aetna Setting Professional Modifier None Typical Low $69.18 Median $104.71 Typical High $398.11 | Professional | None | $69.18 | $104.71 | $398.11 |
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 $66.07 Median $100.00 Typical High $165.96 | Professional | None | $66.07 | $100.00 | $165.96 |
Cigna Setting Facility Modifier None Typical Low $54.95 Median $69.18 Typical High $912.01 | Facility | None | $54.95 | $69.18 | $912.01 |
Hometown Health Setting Professional Modifier None Typical Low $61.66 Median $89.13 Typical High $151.36 | Professional | None | $61.66 | $89.13 | $151.36 |
Hometown Health Setting Facility Modifier None Typical Low $57.54 Median $57.54 Typical High $57.54 | Facility | None | $57.54 | $57.54 | $57.54 |
Hometown Health Setting Professional Modifier None Typical Low $83.18 Median $85.11 Typical High $151.36 | Professional | None | $83.18 | $85.11 | $151.36 |
Select Health Setting Facility Modifier None Typical Low $56.23 Median $100.00 Typical High $4,265.80 | Facility | None | $56.23 | $100.00 | $4,265.80 |
Select Health Setting Professional Modifier None Typical Low $58.88 Median $58.88 Typical High $58.88 | Professional | None | $58.88 | $58.88 | $58.88 |
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 $69.18 Median $102.33 Typical High $147.91 | Professional | None | $69.18 | $102.33 | $147.91 |
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 $34.67 Median $51.29 Typical High $52.48 | Professional | 52 · Reduced service | $34.67 | $51.29 | $52.48 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $14.13 Median $20.42 Typical High $20.89 | Professional | 53 · Discontinued | $14.13 | $20.42 | $20.89 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $52.48 Median $75.86 Typical High $79.43 | Professional | 54 · Surgery only | $52.48 | $75.86 | $79.43 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $10.47 Median $15.14 Typical High $15.85 | Professional | 55 · Aftercare only | $10.47 | $15.14 | $15.85 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $6.92 Median $10.23 Typical High $10.47 | Professional | 56 · Pre-op care only | $6.92 | $10.23 | $10.47 |
Where Nevada sits
The same service costs 3.4 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· 35th of 51
$105
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.