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 $66.07 Median $2,137.96 Typical High $10,715.19 | Facility | None | $66.07 | $2,137.96 | $10,715.19 |
Aetna Setting Professional Modifier None Typical Low $66.07 Median $93.33 Typical High $102.33 | Professional | None | $66.07 | $93.33 | $102.33 |
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 $67.61 Median $77.62 Typical High $120.23 | Professional | None | $67.61 | $77.62 | $120.23 |
Cigna Setting Facility Modifier None Typical Low $77.62 Median $91.20 Typical High $141.25 | Facility | None | $77.62 | $91.20 | $141.25 |
Cigna Setting Professional Modifier None Typical Low $57.54 Median $81.28 Typical High $134.90 | Professional | None | $57.54 | $81.28 | $134.90 |
Hometown Health Setting Professional Modifier None Typical Low $48.98 Median $83.18 Typical High $141.25 | Professional | None | $48.98 | $83.18 | $141.25 |
Hometown Health Setting Facility Modifier None Typical Low $83.18 Median $83.18 Typical High $83.18 | Facility | None | $83.18 | $83.18 | $83.18 |
Hometown Health Setting Professional Modifier None Typical Low $0.78 Median $100.00 Typical High $169.82 | Professional | None | $0.78 | $100.00 | $169.82 |
Select Health Setting Facility Modifier None Typical Low $66.07 Median $112.20 Typical High $4,265.80 | Facility | None | $66.07 | $112.20 | $4,265.80 |
Select Health Setting Professional Modifier None Typical Low $52.48 Median $91.20 Typical High $109.65 | Professional | None | $52.48 | $91.20 | $109.65 |
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 $51.29 Median $81.28 Typical High $134.90 | Professional | None | $51.29 | $81.28 | $134.90 |
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 $33.11 Median $42.66 Typical High $47.86 | Professional | 52 · Reduced service | $33.11 | $42.66 | $47.86 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $13.49 Median $16.98 Typical High $19.50 | Professional | 53 · Discontinued | $13.49 | $16.98 | $19.50 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $50.12 Median $64.57 Typical High $74.13 | Professional | 54 · Surgery only | $50.12 | $64.57 | $74.13 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $10.00 Median $12.88 Typical High $14.45 | Professional | 55 · Aftercare only | $10.00 | $12.88 | $14.45 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $6.61 Median $8.51 Typical High $9.55 | Professional | 56 · Pre-op care only | $6.61 | $8.51 | $9.55 |
Where Nevada sits
The same service costs 3.8 times more in Alaska than in Florida. 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· 44th of 51
$83.18
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.