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 $57.54 Median $2,137.96 Typical High $10,715.19 | Facility | None | $57.54 | $2,137.96 | $10,715.19 |
Aetna Setting Professional Modifier None Typical Low $56.23 Median $95.50 Typical High $144.54 | Professional | None | $56.23 | $95.50 | $144.54 |
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 $61.66 Median $131.83 Typical High $204.17 | Professional | None | $61.66 | $131.83 | $204.17 |
Cigna Setting Facility Modifier None Typical Low $89.13 Median $102.33 Typical High $162.18 | Facility | None | $89.13 | $102.33 | $162.18 |
Cigna Setting Professional Modifier None Typical Low $52.48 Median $93.33 Typical High $177.83 | Professional | None | $52.48 | $93.33 | $177.83 |
Hometown Health Setting Professional Modifier None Typical Low $56.23 Median $102.33 Typical High $199.53 | Professional | None | $56.23 | $102.33 | $199.53 |
Hometown Health Setting Facility Modifier None Typical Low $93.33 Median $93.33 Typical High $93.33 | Facility | None | $93.33 | $93.33 | $93.33 |
Hometown Health Setting Professional Modifier None Typical Low $1.20 Median $75.86 Typical High $199.53 | Professional | None | $1.20 | $75.86 | $199.53 |
Select Health Setting Facility Modifier None Typical Low $51.29 Median $131.83 Typical High $4,265.80 | Facility | None | $51.29 | $131.83 | $4,265.80 |
Select Health Setting Professional Modifier None Typical Low $53.70 Median $53.70 Typical High $53.70 | Professional | None | $53.70 | $53.70 | $53.70 |
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 $61.66 Median $100.00 Typical High $169.82 | Professional | None | $61.66 | $100.00 | $169.82 |
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 $28.84 Median $45.71 Typical High $67.61 | Professional | 52 · Reduced service | $28.84 | $45.71 | $67.61 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $11.48 Median $18.20 Typical High $26.92 | Professional | 53 · Discontinued | $11.48 | $18.20 | $26.92 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $42.66 Median $69.18 Typical High $102.33 | Professional | 54 · Surgery only | $42.66 | $69.18 | $102.33 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $8.71 Median $13.80 Typical High $20.42 | Professional | 55 · Aftercare only | $8.71 | $13.80 | $20.42 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $5.75 Median $9.12 Typical High $13.49 | Professional | 56 · Pre-op care only | $5.75 | $9.12 | $13.49 |
Where Nevada sits
The same service costs 3.1 times more in Alaska than in Kentucky. 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· 42nd of 51
$110
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.