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 $26.30 Median $1,698.24 Typical High $4,365.16 | Facility | None | $26.30 | $1,698.24 | $4,365.16 |
Aetna Setting Professional Modifier None Typical Low $25.12 Median $44.67 Typical High $66.07 | Professional | None | $25.12 | $44.67 | $66.07 |
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 $26.92 Median $54.95 Typical High $87.10 | Professional | None | $26.92 | $54.95 | $87.10 |
Cigna Setting Facility Modifier None Typical Low $38.02 Median $43.65 Typical High $67.61 | Facility | None | $38.02 | $43.65 | $67.61 |
Cigna Setting Professional Modifier None Typical Low $23.99 Median $44.67 Typical High $72.44 | Professional | None | $23.99 | $44.67 | $72.44 |
Hometown Health Setting Professional Modifier None Typical Low $26.30 Median $43.65 Typical High $89.13 | Professional | None | $26.30 | $43.65 | $89.13 |
Hometown Health Setting Facility Modifier None Typical Low $39.81 Median $39.81 Typical High $39.81 | Facility | None | $39.81 | $39.81 | $39.81 |
Hometown Health Setting Professional Modifier None Typical Low $0.48 Median $35.48 Typical High $89.13 | Professional | None | $0.48 | $35.48 | $89.13 |
Select Health Setting Facility Modifier None Typical Low $23.99 Median $58.88 Typical High $4,265.80 | Facility | None | $23.99 | $58.88 | $4,265.80 |
Select Health Setting Professional Modifier None Typical Low $25.12 Median $25.12 Typical High $25.12 | Professional | None | $25.12 | $25.12 | $25.12 |
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 $28.18 Median $46.77 Typical High $75.86 | Professional | None | $28.18 | $46.77 | $75.86 |
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 $12.59 Median $21.38 Typical High $28.18 | Professional | 52 · Reduced service | $12.59 | $21.38 | $28.18 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $5.01 Median $8.71 Typical High $11.22 | Professional | 53 · Discontinued | $5.01 | $8.71 | $11.22 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $19.05 Median $32.36 Typical High $41.69 | Professional | 54 · Surgery only | $19.05 | $32.36 | $41.69 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $3.80 Median $6.46 Typical High $8.32 | Professional | 55 · Aftercare only | $3.80 | $6.46 | $8.32 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $2.51 Median $4.27 Typical High $5.62 | Professional | 56 · Pre-op care only | $2.51 | $4.27 | $5.62 |
Where Nevada sits
The same service costs 3.3 times more in Alaska than in New Jersey. 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
$53.70
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.