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 $87.10 Median $1,698.24 Typical High $4,466.84 | Facility | None | $87.10 | $1,698.24 | $4,466.84 |
Aetna Setting Professional Modifier None Typical Low $81.28 Median $81.28 Typical High $114.82 | Professional | None | $81.28 | $81.28 | $114.82 |
Anthem BCBS Setting Facility Modifier None Typical Low $2,570.40 Median $3,801.89 Typical High $5,128.61 | Facility | None | $2,570.40 | $3,801.89 | $5,128.61 |
Anthem BCBS Setting Professional Modifier None Typical Low $77.62 Median $93.33 Typical High $165.96 | Professional | None | $77.62 | $93.33 | $165.96 |
Cigna Setting Facility Modifier None Typical Low $562.34 Median $912.01 Typical High $6,309.57 | Facility | None | $562.34 | $912.01 | $6,309.57 |
Cigna Setting Professional Modifier None Typical Low $77.62 Median $81.28 Typical High $141.25 | Professional | None | $77.62 | $81.28 | $141.25 |
Hometown Health Setting Professional Modifier None Typical Low $2.45 Median $83.18 Typical High $123.03 | Professional | None | $2.45 | $83.18 | $123.03 |
Hometown Health Setting Professional Modifier None Typical Low $2.09 Median $2.09 Typical High $104.71 | Professional | None | $2.09 | $2.09 | $104.71 |
Select Health Setting Facility Modifier None Typical Low $69.18 Median $69.18 Typical High $4,265.80 | Facility | None | $69.18 | $69.18 | $4,265.80 |
Select Health Setting Professional Modifier None Typical Low $63.10 Median $63.10 Typical High $63.10 | Professional | None | $63.10 | $63.10 | $63.10 |
United Setting Facility Modifier None Typical Low $302.00 Median $794.33 Typical High $2,951.21 | Facility | None | $302.00 | $794.33 | $2,951.21 |
United Setting Professional Modifier None Typical Low $72.44 Median $95.50 Typical High $154.88 | Professional | None | $72.44 | $95.50 | $154.88 |
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 $40.74 Median $40.74 Typical High $42.66 | Professional | 52 · Reduced service | $40.74 | $40.74 | $42.66 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $16.60 Median $16.60 Typical High $17.38 | Professional | 53 · Discontinued | $16.60 | $16.60 | $17.38 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $61.66 Median $61.66 Typical High $64.57 | Professional | 54 · Surgery only | $61.66 | $61.66 | $64.57 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $12.30 Median $12.30 Typical High $12.88 | Professional | 55 · Aftercare only | $12.30 | $12.30 | $12.88 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $8.13 Median $8.13 Typical High $8.71 | Professional | 56 · Pre-op care only | $8.13 | $8.13 | $8.71 |
Where Nevada sits
The same service costs 6.5 times more in Tennessee than in New York. 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· 41st of 51
$110
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.