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 $173.78 Median $2,137.96 Typical High $10,715.19 | Facility | None | $173.78 | $2,137.96 | $10,715.19 |
Aetna Setting Professional Modifier None Typical Low $173.78 Median $275.42 Typical High $302.00 | Professional | None | $173.78 | $275.42 | $302.00 |
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 $173.78 Median $204.17 Typical High $323.59 | Professional | None | $173.78 | $204.17 | $323.59 |
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 $147.91 Median $234.42 Typical High $363.08 | Professional | None | $147.91 | $234.42 | $363.08 |
Hometown Health Setting Professional Modifier None Typical Low $123.03 Median $204.17 Typical High $416.87 | Professional | None | $123.03 | $204.17 | $416.87 |
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 $2.34 Median $239.88 Typical High $501.19 | Professional | None | $2.34 | $239.88 | $501.19 |
Select Health Setting Facility Modifier None Typical Low $165.96 Median $338.84 Typical High $4,265.80 | Facility | None | $165.96 | $338.84 | $4,265.80 |
Select Health Setting Professional Modifier None Typical Low $134.90 Median $245.47 Typical High $316.23 | Professional | None | $134.90 | $245.47 | $316.23 |
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 $158.49 Median $223.87 Typical High $389.05 | Professional | None | $158.49 | $223.87 | $389.05 |
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 $85.11 Median $112.20 Typical High $144.54 | Professional | 52 · Reduced service | $85.11 | $112.20 | $144.54 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $34.67 Median $44.67 Typical High $57.54 | Professional | 53 · Discontinued | $34.67 | $44.67 | $57.54 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $128.82 Median $169.82 Typical High $218.78 | Professional | 54 · Surgery only | $128.82 | $169.82 | $218.78 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $25.70 Median $33.88 Typical High $43.65 | Professional | 55 · Aftercare only | $25.70 | $33.88 | $43.65 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $17.38 Median $22.39 Typical High $28.84 | Professional | 56 · Pre-op care only | $17.38 | $22.39 | $28.84 |
Where Nevada sits
The same service costs 4.0 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
$224
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.