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 $69.18 Median $1,698.24 Typical High $4,365.16 | Facility | None | $69.18 | $1,698.24 | $4,365.16 |
Aetna Setting Professional Modifier None Typical Low $66.07 Median $134.90 Typical High $158.49 | Professional | None | $66.07 | $134.90 | $158.49 |
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 $69.18 Median $151.36 Typical High $257.04 | Professional | None | $69.18 | $151.36 | $257.04 |
Cigna Setting Facility Modifier None Typical Low $398.11 Median $776.25 Typical High $1,122.02 | Facility | None | $398.11 | $776.25 | $1,122.02 |
Cigna Setting Professional Modifier None Typical Low $57.54 Median $125.89 Typical High $213.80 | Professional | None | $57.54 | $125.89 | $213.80 |
Hometown Health Setting Professional Modifier None Typical Low $61.66 Median $147.91 Typical High $933.25 | Professional | None | $61.66 | $147.91 | $933.25 |
Hometown Health Setting Facility Modifier None Typical Low $776.25 Median $776.25 Typical High $776.25 | Facility | None | $776.25 | $776.25 | $776.25 |
Hometown Health Setting Professional Modifier None Typical Low $0.66 Median $91.20 Typical High $1,174.90 | Professional | None | $0.66 | $91.20 | $1,174.90 |
Select Health Setting Facility Modifier None Typical Low $60.26 Median $162.18 Typical High $4,265.80 | Facility | None | $60.26 | $162.18 | $4,265.80 |
Select Health Setting Professional Modifier None Typical Low $144.54 Median $144.54 Typical High $144.54 | Professional | None | $144.54 | $144.54 | $144.54 |
United Setting Facility Modifier None Typical Low $467.74 Median $724.44 Typical High $2,884.03 | Facility | None | $467.74 | $724.44 | $2,884.03 |
United Setting Professional Modifier None Typical Low $58.88 Median $131.83 Typical High $223.87 | Professional | None | $58.88 | $131.83 | $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 $33.11 Median $46.77 Typical High $75.86 | Professional | 52 · Reduced service | $33.11 | $46.77 | $75.86 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $13.18 Median $18.62 Typical High $30.20 | Professional | 53 · Discontinued | $13.18 | $18.62 | $30.20 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $50.12 Median $70.79 Typical High $114.82 | Professional | 54 · Surgery only | $50.12 | $70.79 | $114.82 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $10.00 Median $14.13 Typical High $22.91 | Professional | 55 · Aftercare only | $10.00 | $14.13 | $22.91 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $6.61 Median $9.33 Typical High $15.14 | Professional | 56 · Pre-op care only | $6.61 | $9.33 | $15.14 |
Where Nevada sits
The same service costs 4.9 times more in Alaska than in Hawaii. 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
$151
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.