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 $87.10 Median $1,698.24 Typical High $4,365.16 | Facility | None | $87.10 | $1,698.24 | $4,365.16 |
Aetna Setting Professional Modifier None Typical Low $79.43 Median $208.93 Typical High $338.84 | Professional | None | $79.43 | $208.93 | $338.84 |
Ambetter Setting Professional Modifier None Typical Low $63.10 Median $63.10 Typical High $302.00 | Professional | None | $63.10 | $63.10 | $302.00 |
Anthem BCBS Setting Professional Modifier None Typical Low $79.43 Median $97.72 Typical High $177.83 | Professional | None | $79.43 | $97.72 | $177.83 |
Cigna Setting Professional Modifier None Typical Low $67.61 Median $204.17 Typical High $446.68 | Professional | None | $67.61 | $204.17 | $446.68 |
Hometown Health Setting Professional Modifier None Typical Low $67.61 Median $138.04 Typical High $489.78 | Professional | None | $67.61 | $138.04 | $489.78 |
Hometown Health Setting Professional Modifier None Typical Low $2.40 Median $102.33 Typical High $489.78 | Professional | None | $2.40 | $102.33 | $489.78 |
Select Health Setting Facility Modifier None Typical Low $69.18 Median $323.59 Typical High $4,265.80 | Facility | None | $69.18 | $323.59 | $4,265.80 |
Select Health Setting Professional Modifier None Typical Low $52.48 Median $52.48 Typical High $69.18 | Professional | None | $52.48 | $52.48 | $69.18 |
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 $81.28 Median $257.04 Typical High $457.09 | Professional | None | $81.28 | $257.04 | $457.09 |
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 $39.81 Median $85.11 Typical High $169.82 | Professional | 52 · Reduced service | $39.81 | $85.11 | $169.82 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $15.85 Median $33.88 Typical High $67.61 | Professional | 53 · Discontinued | $15.85 | $33.88 | $67.61 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $60.26 Median $128.82 Typical High $257.04 | Professional | 54 · Surgery only | $60.26 | $128.82 | $257.04 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $12.02 Median $25.70 Typical High $51.29 | Professional | 55 · Aftercare only | $12.02 | $25.70 | $51.29 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $7.94 Median $16.98 Typical High $33.88 | Professional | 56 · Pre-op care only | $7.94 | $16.98 | $33.88 |
Where Nevada sits
The same service costs 4.2 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
$162
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.