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 $147.91 Median $2,238.72 Typical High $5,011.87 | Facility | None | $147.91 | $2,238.72 | $5,011.87 |
Aetna Setting Professional Modifier None Typical Low $85.11 Median $131.83 Typical High $194.98 | Professional | None | $85.11 | $131.83 | $194.98 |
Anthem BCBS Setting Facility Modifier None Typical Low $2,570.40 Median $3,801.89 Typical High $5,128.61 | Facility | None | $2,570.40 | $3,801.89 | $5,128.61 |
Anthem BCBS Setting Professional Modifier None Typical Low $91.20 Median $158.49 Typical High $239.88 | Professional | None | $91.20 | $158.49 | $239.88 |
Cigna Setting Facility Modifier None Typical Low $97.72 Median $123.03 Typical High $912.01 | Facility | None | $97.72 | $123.03 | $912.01 |
Cigna Setting Professional Modifier None Typical Low $85.11 Median $128.82 Typical High $190.55 | Professional | None | $85.11 | $128.82 | $190.55 |
Hometown Health Setting Professional Modifier None Typical Low $91.20 Median $128.82 Typical High $239.88 | Professional | None | $91.20 | $128.82 | $239.88 |
Hometown Health Setting Facility Modifier None Typical Low $97.72 Median $97.72 Typical High $97.72 | Facility | None | $97.72 | $97.72 | $97.72 |
Hometown Health Setting Professional Modifier None Typical Low $1.51 Median $125.89 Typical High $239.88 | Professional | None | $1.51 | $125.89 | $239.88 |
Select Health Setting Facility Modifier None Typical Low $83.18 Median $158.49 Typical High $4,265.80 | Facility | None | $83.18 | $158.49 | $4,265.80 |
Select Health Setting Professional Modifier None Typical Low $87.10 Median $87.10 Typical High $87.10 | Professional | None | $87.10 | $87.10 | $87.10 |
United Setting Facility Modifier None Typical Low $467.74 Median $776.25 Typical High $2,884.03 | Facility | None | $467.74 | $776.25 | $2,884.03 |
United Setting Professional Modifier None Typical Low $100.00 Median $158.49 Typical High $223.87 | Professional | None | $100.00 | $158.49 | $223.87 |
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 $42.66 Median $63.10 Typical High $77.62 | Professional | 52 · Reduced service | $42.66 | $63.10 | $77.62 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $16.98 Median $25.12 Typical High $30.90 | Professional | 53 · Discontinued | $16.98 | $25.12 | $30.90 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $64.57 Median $95.50 Typical High $114.82 | Professional | 54 · Surgery only | $64.57 | $95.50 | $114.82 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $12.88 Median $19.05 Typical High $22.91 | Professional | 55 · Aftercare only | $12.88 | $19.05 | $22.91 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $8.51 Median $12.59 Typical High $15.49 | Professional | 56 · Pre-op care only | $8.51 | $12.59 | $15.49 |
Where Nevada sits
The same service costs 3.2 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· 33rd of 51
$155
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.