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 $1,230.27 Median $2,570.40 Typical High $6,165.95 | Facility | None | $1,230.27 | $2,570.40 | $6,165.95 |
Aetna Setting Professional Modifier None Typical Low $1,122.02 Median $1,174.90 Typical High $2,570.40 | Professional | None | $1,122.02 | $1,174.90 | $2,570.40 |
Anthem BCBS Setting Facility Modifier None Typical Low $2,754.23 Median $4,466.84 Typical High $5,754.40 | Facility | None | $2,754.23 | $4,466.84 | $5,754.40 |
Anthem BCBS Setting Professional Modifier None Typical Low $1,230.27 Median $1,513.56 Typical High $2,238.72 | Professional | None | $1,230.27 | $1,513.56 | $2,238.72 |
Cigna Setting Facility Modifier None Typical Low $616.60 Median $2,137.96 Typical High $2,884.03 | Facility | None | $616.60 | $2,137.96 | $2,884.03 |
Cigna Setting Professional Modifier None Typical Low $1,047.13 Median $1,288.25 Typical High $1,819.70 | Professional | None | $1,047.13 | $1,288.25 | $1,819.70 |
Hometown Health Setting Professional Modifier None Typical Low $5.01 Median $5.01 Typical High $5.62 | Professional | None | $5.01 | $5.01 | $5.62 |
Hometown Health Setting Facility Modifier None Typical Low $2,041.74 Median $2,041.74 Typical High $2,041.74 | Facility | None | $2,041.74 | $2,041.74 | $2,041.74 |
Hometown Health Setting Professional Modifier None Typical Low $4.27 Median $4.27 Typical High $4.27 | Professional | None | $4.27 | $4.27 | $4.27 |
Select Health Setting Facility Modifier None Typical Low $4,265.80 Median $4,265.80 Typical High $4,265.80 | Facility | None | $4,265.80 | $4,265.80 | $4,265.80 |
United Setting Facility Modifier None Typical Low $1,174.90 Median $1,698.24 Typical High $4,073.80 | Facility | None | $1,174.90 | $1,698.24 | $4,073.80 |
United Setting Professional Modifier None Typical Low $891.25 Median $1,230.27 Typical High $1,949.84 | Professional | None | $891.25 | $1,230.27 | $1,949.84 |
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 $562.34 Median $588.84 Typical High $616.60 | Professional | 52 · Reduced service | $562.34 | $588.84 | $616.60 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $223.87 Median $234.42 Typical High $245.47 | Professional | 53 · Discontinued | $223.87 | $234.42 | $245.47 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $831.76 Median $891.25 Typical High $933.25 | Professional | 54 · Surgery only | $831.76 | $891.25 | $933.25 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $165.96 Median $177.83 Typical High $186.21 | Professional | 55 · Aftercare only | $165.96 | $177.83 | $186.21 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $112.20 Median $117.49 Typical High $123.03 | Professional | 56 · Pre-op care only | $112.20 | $117.49 | $123.03 |
Where Nevada sits
The same service costs 4.8 times more in Alaska than in New York. 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· 25th of 51
$1,514
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.