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 $134.90 Median $2,137.96 Typical High $10,715.19 | Facility | None | $134.90 | $2,137.96 | $10,715.19 |
Aetna Setting Professional Modifier None Typical Low $134.90 Median $239.88 Typical High $263.03 | Professional | None | $134.90 | $239.88 | $263.03 |
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 $138.04 Median $162.18 Typical High $263.03 | Professional | None | $138.04 | $162.18 | $263.03 |
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 $120.23 Median $213.80 Typical High $323.59 | Professional | None | $120.23 | $213.80 | $323.59 |
Hometown Health Setting Professional Modifier None Typical Low $91.20 Median $177.83 Typical High $371.54 | Professional | None | $91.20 | $177.83 | $371.54 |
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 $1.07 Median $204.17 Typical High $446.68 | Professional | None | $1.07 | $204.17 | $446.68 |
Select Health Setting Facility Modifier None Typical Low $138.04 Median $295.12 Typical High $4,265.80 | Facility | None | $138.04 | $295.12 | $4,265.80 |
Select Health Setting Professional Modifier None Typical Low $109.65 Median $204.17 Typical High $281.84 | Professional | None | $109.65 | $204.17 | $281.84 |
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 $128.82 Median $204.17 Typical High $338.84 | Professional | None | $128.82 | $204.17 | $338.84 |
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 $67.61 Median $97.72 Typical High $128.82 | Professional | 52 · Reduced service | $67.61 | $97.72 | $128.82 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $27.54 Median $39.81 Typical High $51.29 | Professional | 53 · Discontinued | $27.54 | $39.81 | $51.29 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $102.33 Median $147.91 Typical High $194.98 | Professional | 54 · Surgery only | $102.33 | $147.91 | $194.98 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $20.42 Median $29.51 Typical High $38.02 | Professional | 55 · Aftercare only | $20.42 | $29.51 | $38.02 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $13.49 Median $19.95 Typical High $25.70 | Professional | 56 · Pre-op care only | $13.49 | $19.95 | $25.70 |
Where Nevada sits
The same service costs 4.1 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· 46th of 51
$195
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.