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 $151.36 Median $2,137.96 Typical High $10,715.19 | Facility | None | $151.36 | $2,137.96 | $10,715.19 |
Aetna Setting Professional Modifier None Typical Low $151.36 Median $257.04 Typical High $281.84 | Professional | None | $151.36 | $257.04 | $281.84 |
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 $154.88 Median $177.83 Typical High $275.42 | Professional | None | $154.88 | $177.83 | $275.42 |
Cigna Setting Facility Modifier None Typical Low $151.36 Median $177.83 Typical High $275.42 | Facility | None | $151.36 | $177.83 | $275.42 |
Cigna Setting Professional Modifier None Typical Low $117.49 Median $181.97 Typical High $331.13 | Professional | None | $117.49 | $181.97 | $331.13 |
Hometown Health Setting Professional Modifier None Typical Low $102.33 Median $181.97 Typical High $398.11 | Professional | None | $102.33 | $181.97 | $398.11 |
Hometown Health Setting Facility Modifier None Typical Low $162.18 Median $162.18 Typical High $162.18 | Facility | None | $162.18 | $162.18 | $162.18 |
Hometown Health Setting Professional Modifier None Typical Low $1.91 Median $229.09 Typical High $467.74 | Professional | None | $1.91 | $229.09 | $467.74 |
Select Health Setting Facility Modifier None Typical Low $151.36 Median $316.23 Typical High $4,265.80 | Facility | None | $151.36 | $316.23 | $4,265.80 |
Select Health Setting Professional Modifier None Typical Low $120.23 Median $223.87 Typical High $302.00 | Professional | None | $120.23 | $223.87 | $302.00 |
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 $151.36 Median $223.87 Typical High $363.08 | Professional | None | $151.36 | $223.87 | $363.08 |
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 $75.86 Median $114.82 Typical High $138.04 | Professional | 52 · Reduced service | $75.86 | $114.82 | $138.04 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $30.20 Median $45.71 Typical High $54.95 | Professional | 53 · Discontinued | $30.20 | $45.71 | $54.95 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $114.82 Median $169.82 Typical High $208.93 | Professional | 54 · Surgery only | $114.82 | $169.82 | $208.93 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $22.91 Median $33.88 Typical High $40.74 | Professional | 55 · Aftercare only | $22.91 | $33.88 | $40.74 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $15.14 Median $22.91 Typical High $27.54 | Professional | 56 · Pre-op care only | $15.14 | $22.91 | $27.54 |
Where Nevada sits
The same service costs 3.6 times more in Alaska than in Maryland. 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· 47th of 51
$200
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.