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 $45.71 Median $1,698.24 Typical High $4,466.84 | Facility | None | $45.71 | $1,698.24 | $4,466.84 |
Aetna Setting Professional Modifier None Typical Low $38.90 Median $43.65 Typical High $60.26 | Professional | None | $38.90 | $43.65 | $60.26 |
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 $45.71 Median $56.23 Typical High $83.18 | Professional | None | $45.71 | $56.23 | $83.18 |
Cigna Setting Facility Modifier None Typical Low $54.95 Median $741.31 Typical High $2,137.96 | Facility | None | $54.95 | $741.31 | $2,137.96 |
Cigna Setting Professional Modifier None Typical Low $38.90 Median $53.70 Typical High $77.62 | Professional | None | $38.90 | $53.70 | $77.62 |
Hometown Health Setting Professional Modifier None Typical Low $1.26 Median $45.71 Typical High $60.26 | Professional | None | $1.26 | $45.71 | $60.26 |
Hometown Health Setting Professional Modifier None Typical Low $1.07 Median $1.07 Typical High $57.54 | Professional | None | $1.07 | $1.07 | $57.54 |
Select Health Setting Facility Modifier None Typical Low $38.02 Median $38.02 Typical High $4,265.80 | Facility | None | $38.02 | $38.02 | $4,265.80 |
Select Health Setting Professional Modifier None Typical Low $39.81 Median $39.81 Typical High $39.81 | Professional | None | $39.81 | $39.81 | $39.81 |
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 $25.70 Median $46.77 Typical High $87.10 | Professional | None | $25.70 | $46.77 | $87.10 |
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 $20.42 Median $21.88 Typical High $22.91 | Professional | 52 · Reduced service | $20.42 | $21.88 | $22.91 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $8.13 Median $8.71 Typical High $9.12 | Professional | 53 · Discontinued | $8.13 | $8.71 | $9.12 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $30.90 Median $33.11 Typical High $34.67 | Professional | 54 · Surgery only | $30.90 | $33.11 | $34.67 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $6.17 Median $6.61 Typical High $6.92 | Professional | 55 · Aftercare only | $6.17 | $6.61 | $6.92 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $4.07 Median $4.37 Typical High $4.57 | Professional | 56 · Pre-op care only | $4.07 | $4.37 | $4.57 |
Where Nevada sits
The same service costs 13.8 times more in Oklahoma 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· 37th of 51
$56.23
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.