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 $46.77 Median $1,698.24 Typical High $4,365.16 | Facility | None | $46.77 | $1,698.24 | $4,365.16 |
Aetna Setting Professional Modifier None Typical Low $42.66 Median $147.91 Typical High $229.09 | Professional | None | $42.66 | $147.91 | $229.09 |
Anthem BCBS Setting Professional Modifier None Typical Low $43.65 Median $53.70 Typical High $95.50 | Professional | None | $43.65 | $53.70 | $95.50 |
Cigna Setting Professional Modifier None Typical Low $34.67 Median $125.89 Typical High $309.03 | Professional | None | $34.67 | $125.89 | $309.03 |
Hometown Health Setting Professional Modifier None Typical Low $35.48 Median $75.86 Typical High $331.13 | Professional | None | $35.48 | $75.86 | $331.13 |
Hometown Health Setting Professional Modifier None Typical Low $0.78 Median $57.54 Typical High $331.13 | Professional | None | $0.78 | $57.54 | $331.13 |
Select Health Setting Facility Modifier None Typical Low $38.02 Median $223.87 Typical High $4,265.80 | Facility | None | $38.02 | $223.87 | $4,265.80 |
Select Health Setting Professional Modifier None Typical Low $28.84 Median $28.84 Typical High $38.02 | Professional | None | $28.84 | $28.84 | $38.02 |
United Setting Facility Modifier None Typical Low $251.19 Median $1,412.54 Typical High $2,041.74 | Facility | None | $251.19 | $1,412.54 | $2,041.74 |
United Setting Professional Modifier None Typical Low $38.02 Median $158.49 Typical High $316.23 | Professional | None | $38.02 | $158.49 | $316.23 |
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 $21.38 Median $46.77 Typical High $114.82 | Professional | 52 · Reduced service | $21.38 | $46.77 | $114.82 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $8.51 Median $18.62 Typical High $46.77 | Professional | 53 · Discontinued | $8.51 | $18.62 | $46.77 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $32.36 Median $70.79 Typical High $173.78 | Professional | 54 · Surgery only | $32.36 | $70.79 | $173.78 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $6.46 Median $14.13 Typical High $34.67 | Professional | 55 · Aftercare only | $6.46 | $14.13 | $34.67 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $4.27 Median $9.33 Typical High $22.91 | Professional | 56 · Pre-op care only | $4.27 | $9.33 | $22.91 |
Where Nevada sits
The same service costs 5.8 times more in Washington than in Virginia. 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· 42nd of 51
$87.10
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.