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 $75.86 Median $1,698.24 Typical High $4,365.16 | Facility | None | $75.86 | $1,698.24 | $4,365.16 |
Aetna Setting Professional Modifier None Typical Low $72.44 Median $245.47 Typical High $257.04 | Professional | None | $72.44 | $245.47 | $257.04 |
Anthem BCBS Setting Professional Modifier None Typical Low $77.62 Median $223.87 Typical High $446.68 | Professional | None | $77.62 | $223.87 | $446.68 |
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 |
Cigna Setting Professional Modifier None Typical Low $67.61 Median $229.09 Typical High $346.74 | Professional | None | $67.61 | $229.09 | $346.74 |
Hometown Health Setting Professional Modifier None Typical Low $74.13 Median $117.49 Typical High $371.54 | Professional | None | $74.13 | $117.49 | $371.54 |
Hometown Health Setting Professional Modifier None Typical Low $0.72 Median $97.72 Typical High $354.81 | Professional | None | $0.72 | $97.72 | $354.81 |
Select Health Setting Facility Modifier None Typical Low $64.57 Median $234.42 Typical High $4,265.80 | Facility | None | $64.57 | $234.42 | $4,265.80 |
Select Health Setting Professional Modifier None Typical Low $208.93 Median $208.93 Typical High $208.93 | Professional | None | $208.93 | $208.93 | $208.93 |
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 $83.18 Median $234.42 Typical High $416.87 | Professional | None | $83.18 | $234.42 | $416.87 |
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 $36.31 Median $56.23 Typical High $128.82 | Professional | 52 · Reduced service | $36.31 | $56.23 | $128.82 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $14.45 Median $22.39 Typical High $51.29 | Professional | 53 · Discontinued | $14.45 | $22.39 | $51.29 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $54.95 Median $83.18 Typical High $190.55 | Professional | 54 · Surgery only | $54.95 | $83.18 | $190.55 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $10.96 Median $16.98 Typical High $38.02 | Professional | 55 · Aftercare only | $10.96 | $16.98 | $38.02 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $7.24 Median $11.22 Typical High $25.70 | Professional | 56 · Pre-op care only | $7.24 | $11.22 | $25.70 |
Where Nevada sits
The same service costs 4.5 times more in Oklahoma than in Nebraska. 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· 30th of 51
$234
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.