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 $316.23 Median $1,698.24 Typical High $4,466.84 | Facility | None | $316.23 | $1,698.24 | $4,466.84 |
Aetna Setting Professional Modifier None Typical Low $147.91 Median $316.23 Typical High $1,698.24 | Professional | None | $147.91 | $316.23 | $1,698.24 |
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 $295.12 Median $354.81 Typical High $537.03 | Professional | None | $295.12 | $354.81 | $537.03 |
Cigna Setting Facility Modifier None Typical Low $426.58 Median $524.81 Typical High $1,000.00 | Facility | None | $426.58 | $524.81 | $1,000.00 |
Hometown Health Setting Facility Modifier None Typical Low $426.58 Median $426.58 Typical High $426.58 | Facility | None | $426.58 | $426.58 | $426.58 |
Select Health Setting Facility Modifier None Typical Low $194.98 Median $363.08 Typical High $4,265.80 | Facility | None | $194.98 | $363.08 | $4,265.80 |
Select Health Setting Professional Modifier None Typical Low $204.17 Median $204.17 Typical High $204.17 | Professional | None | $204.17 | $204.17 | $204.17 |
United Setting Facility Modifier None Typical Low $302.00 Median $512.86 Typical High $2,137.96 | Facility | None | $302.00 | $512.86 | $2,137.96 |
United Setting Professional Modifier None Typical Low $165.96 Median $275.42 Typical High $407.38 | Professional | None | $165.96 | $275.42 | $407.38 |
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 $138.04 Median $158.49 Typical High $158.49 | Professional | 52 · Reduced service | $138.04 | $158.49 | $158.49 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $54.95 Median $64.57 Typical High $64.57 | Professional | 53 · Discontinued | $54.95 | $64.57 | $64.57 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $204.17 Median $239.88 Typical High $239.88 | Professional | 54 · Surgery only | $204.17 | $239.88 | $239.88 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $40.74 Median $47.86 Typical High $47.86 | Professional | 55 · Aftercare only | $40.74 | $47.86 | $47.86 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $27.54 Median $31.62 Typical High $31.62 | Professional | 56 · Pre-op care only | $27.54 | $31.62 | $31.62 |
Where Nevada sits
The same service costs 8.3 times more in Oklahoma than in Rhode Island. 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· 27th of 51
$427
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.