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 $165.96 Median $1,698.24 Typical High $4,365.16 | Facility | None | $165.96 | $1,698.24 | $4,365.16 |
Aetna Setting Professional Modifier None Typical Low $151.36 Median $234.42 Typical High $257.04 | Professional | None | $151.36 | $234.42 | $257.04 |
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 $281.84 | Professional | None | $154.88 | $177.83 | $281.84 |
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 $131.83 Median $204.17 Typical High $316.23 | Professional | None | $131.83 | $204.17 | $316.23 |
Hometown Health Setting Professional Modifier None Typical Low $109.65 Median $181.97 Typical High $354.81 | Professional | None | $109.65 | $181.97 | $354.81 |
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 $1.20 Median $223.87 Typical High $426.58 | Professional | None | $1.20 | $223.87 | $426.58 |
Select Health Setting Facility Modifier None Typical Low $147.91 Median $281.84 Typical High $4,265.80 | Facility | None | $147.91 | $281.84 | $4,265.80 |
Select Health Setting Professional Modifier None Typical Low $120.23 Median $218.78 Typical High $269.15 | Professional | None | $120.23 | $218.78 | $269.15 |
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 $144.54 Median $208.93 Typical High $338.84 | Professional | None | $144.54 | $208.93 | $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 $75.86 Median $109.65 Typical High $123.03 | Professional | 52 · Reduced service | $75.86 | $109.65 | $123.03 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $30.20 Median $44.67 Typical High $50.12 | Professional | 53 · Discontinued | $30.20 | $44.67 | $50.12 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $112.20 Median $165.96 Typical High $190.55 | Professional | 54 · Surgery only | $112.20 | $165.96 | $190.55 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $22.39 Median $33.11 Typical High $37.15 | Professional | 55 · Aftercare only | $22.39 | $33.11 | $37.15 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $15.14 Median $21.88 Typical High $25.12 | Professional | 56 · Pre-op care only | $15.14 | $21.88 | $25.12 |
Where Nevada sits
The same service costs 3.9 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· 46th of 51
$204
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.