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 $91.20 Median $1,698.24 Typical High $4,365.16 | Facility | None | $91.20 | $1,698.24 | $4,365.16 |
Aetna Setting Professional Modifier None Typical Low $81.28 Median $120.23 Typical High $169.82 | Professional | None | $81.28 | $120.23 | $169.82 |
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 $91.20 Median $141.25 Typical High $213.80 | Professional | None | $91.20 | $141.25 | $213.80 |
Cigna Setting Facility Modifier None Typical Low $83.18 Median $102.33 Typical High $549.54 | Facility | None | $83.18 | $102.33 | $549.54 |
Cigna Setting Professional Modifier None Typical Low $81.28 Median $123.03 Typical High $181.97 | Professional | None | $81.28 | $123.03 | $181.97 |
Hometown Health Setting Professional Modifier None Typical Low $87.10 Median $123.03 Typical High $218.78 | Professional | None | $87.10 | $123.03 | $218.78 |
Hometown Health Setting Facility Modifier None Typical Low $83.18 Median $83.18 Typical High $83.18 | Facility | None | $83.18 | $83.18 | $83.18 |
Hometown Health Setting Professional Modifier None Typical Low $0.83 Median $117.49 Typical High $218.78 | Professional | None | $0.83 | $117.49 | $218.78 |
Select Health Setting Facility Modifier None Typical Low $77.62 Median $144.54 Typical High $4,265.80 | Facility | None | $77.62 | $144.54 | $4,265.80 |
Select Health Setting Professional Modifier None Typical Low $83.18 Median $83.18 Typical High $83.18 | Professional | None | $83.18 | $83.18 | $83.18 |
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 $91.20 Median $138.04 Typical High $190.55 | Professional | None | $91.20 | $138.04 | $190.55 |
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 $43.65 Median $58.88 Typical High $70.79 | Professional | 52 · Reduced service | $43.65 | $58.88 | $70.79 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $17.38 Median $23.44 Typical High $28.18 | Professional | 53 · Discontinued | $17.38 | $23.44 | $28.18 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $64.57 Median $87.10 Typical High $104.71 | Professional | 54 · Surgery only | $64.57 | $87.10 | $104.71 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $12.88 Median $17.38 Typical High $20.89 | Professional | 55 · Aftercare only | $12.88 | $17.38 | $20.89 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $8.71 Median $11.75 Typical High $14.13 | Professional | 56 · Pre-op care only | $8.71 | $11.75 | $14.13 |
Where Nevada sits
The same service costs 3.2 times more in Alaska than in Florida. 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· 34th of 51
$141
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.