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 $79.43 Median $87.10 Typical High $125.89 | Facility | None | $79.43 | $87.10 | $125.89 |
Aetna Setting Professional Modifier None Typical Low $79.43 Median $114.82 Typical High $123.03 | Professional | None | $79.43 | $114.82 | $123.03 |
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 $81.28 Median $93.33 Typical High $151.36 | Professional | None | $81.28 | $93.33 | $151.36 |
Cigna Setting Facility Modifier None Typical Low $83.18 Median $97.72 Typical High $151.36 | Facility | None | $83.18 | $97.72 | $151.36 |
Cigna Setting Professional Modifier None Typical Low $66.07 Median $91.20 Typical High $158.49 | Professional | None | $66.07 | $91.20 | $158.49 |
Hometown Health Setting Professional Modifier None Typical Low $57.54 Median $93.33 Typical High $169.82 | Professional | None | $57.54 | $93.33 | $169.82 |
Hometown Health Setting Facility Modifier None Typical Low $87.10 Median $87.10 Typical High $87.10 | Facility | None | $87.10 | $87.10 | $87.10 |
Hometown Health Setting Professional Modifier None Typical Low $0.36 Median $107.15 Typical High $204.17 | Professional | None | $0.36 | $107.15 | $204.17 |
Select Health Setting Facility Modifier None Typical Low $70.79 Median $134.90 Typical High $4,265.80 | Facility | None | $70.79 | $134.90 | $4,265.80 |
Select Health Setting Professional Modifier None Typical Low $56.23 Median $107.15 Typical High $128.82 | Professional | None | $56.23 | $107.15 | $128.82 |
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 $64.57 Median $107.15 Typical High $169.82 | Professional | None | $64.57 | $107.15 | $169.82 |
4 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 $39.81 Median $57.54 Typical High $61.66 | Professional | 52 · Reduced service | $39.81 | $57.54 | $61.66 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $15.85 Median $22.91 Typical High $24.55 | Professional | 53 · Discontinued | $15.85 | $22.91 | $24.55 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $12.02 Median $16.98 Typical High $18.62 | Professional | 55 · Aftercare only | $12.02 | $16.98 | $18.62 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $7.94 Median $11.48 Typical High $12.30 | Professional | 56 · Pre-op care only | $7.94 | $11.48 | $12.30 |
Where Nevada sits
The same service costs 3.5 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
$100
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.