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 $63.10 Median $75.86 Typical High $91.20 | Professional | None | $63.10 | $75.86 | $91.20 |
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 $64.57 Median $93.33 Typical High $141.25 | Professional | None | $64.57 | $93.33 | $141.25 |
Cigna Setting Facility Modifier None Typical Low $54.95 Median $66.07 Typical High $912.01 | Facility | None | $54.95 | $66.07 | $912.01 |
Cigna Setting Professional Modifier None Typical Low $50.12 Median $69.18 Typical High $112.20 | Professional | None | $50.12 | $69.18 | $112.20 |
Hometown Health Setting Professional Modifier None Typical Low $40.74 Median $66.07 Typical High $120.23 | Professional | None | $40.74 | $66.07 | $120.23 |
Hometown Health Setting Facility Modifier None Typical Low $57.54 Median $57.54 Typical High $57.54 | Facility | None | $57.54 | $57.54 | $57.54 |
Hometown Health Setting Professional Modifier None Typical Low $0.89 Median $87.10 Typical High $141.25 | Professional | None | $0.89 | $87.10 | $141.25 |
Select Health Setting Facility Modifier None Typical Low $57.54 Median $93.33 Typical High $4,265.80 | Facility | None | $57.54 | $93.33 | $4,265.80 |
Select Health Setting Professional Modifier None Typical Low $45.71 Median $75.86 Typical High $117.49 | Professional | None | $45.71 | $75.86 | $117.49 |
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 $63.10 Median $85.11 Typical High $123.03 | Professional | None | $63.10 | $85.11 | $123.03 |
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 $31.62 Median $38.02 Typical High $42.66 | Professional | 52 · Reduced service | $31.62 | $38.02 | $42.66 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $12.59 Median $15.14 Typical High $16.98 | Professional | 53 · Discontinued | $12.59 | $15.14 | $16.98 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $46.77 Median $56.23 Typical High $66.07 | Professional | 54 · Surgery only | $46.77 | $56.23 | $66.07 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $9.55 Median $11.48 Typical High $12.88 | Professional | 55 · Aftercare only | $9.55 | $11.48 | $12.88 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $6.31 Median $7.59 Typical High $8.51 | Professional | 56 · Pre-op care only | $6.31 | $7.59 | $8.51 |
Where Nevada sits
The same service costs 3.8 times more in Alaska than in Kentucky. 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· 43rd of 51
$83.18
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.