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 $162.18 Median $2,137.96 Typical High $10,715.19 | Facility | None | $162.18 | $2,137.96 | $10,715.19 |
Aetna Setting Professional Modifier None Typical Low $162.18 Median $245.47 Typical High $302.00 | Professional | None | $162.18 | $245.47 | $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 $165.96 Median $194.98 Typical High $295.12 | Professional | None | $165.96 | $194.98 | $295.12 |
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 $125.89 Median $190.55 Typical High $346.74 | Professional | None | $125.89 | $190.55 | $346.74 |
Hometown Health Setting Professional Modifier None Typical Low $102.33 Median $190.55 Typical High $407.38 | Professional | None | $102.33 | $190.55 | $407.38 |
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 $1.70 Median $239.88 Typical High $501.19 | Professional | None | $1.70 | $239.88 | $501.19 |
Select Health Setting Facility Modifier None Typical Low $162.18 Median $338.84 Typical High $4,265.80 | Facility | None | $162.18 | $338.84 | $4,265.80 |
Select Health Setting Professional Modifier None Typical Low $128.82 Median $239.88 Typical High $323.59 | Professional | None | $128.82 | $239.88 | $323.59 |
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 $147.91 Median $208.93 Typical High $363.08 | Professional | None | $147.91 | $208.93 | $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 $81.28 Median $109.65 Typical High $141.25 | Professional | 52 · Reduced service | $81.28 | $109.65 | $141.25 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $33.11 Median $43.65 Typical High $57.54 | Professional | 53 · Discontinued | $33.11 | $43.65 | $57.54 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $123.03 Median $162.18 Typical High $218.78 | Professional | 54 · Surgery only | $123.03 | $162.18 | $218.78 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $24.55 Median $33.11 Typical High $42.66 | Professional | 55 · Aftercare only | $24.55 | $33.11 | $42.66 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $16.22 Median $21.88 Typical High $28.84 | Professional | 56 · Pre-op care only | $16.22 | $21.88 | $28.84 |
Where Nevada sits
The same service costs 4.0 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.