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 $93.33 Median $2,137.96 Typical High $10,715.19 | Facility | None | $93.33 | $2,137.96 | $10,715.19 |
Aetna Setting Professional Modifier None Typical Low $93.33 Median $131.83 Typical High $138.04 | Professional | None | $93.33 | $131.83 | $138.04 |
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 $89.13 Median $131.83 Typical High $208.93 | Professional | None | $89.13 | $131.83 | $208.93 |
Cigna Setting Facility Modifier None Typical Low $338.84 Median $398.11 Typical High $616.60 | Facility | None | $338.84 | $398.11 | $616.60 |
Cigna Setting Professional Modifier None Typical Low $87.10 Median $117.49 Typical High $190.55 | Professional | None | $87.10 | $117.49 | $190.55 |
Hometown Health Setting Professional Modifier None Typical Low $93.33 Median $141.25 Typical High $436.52 | Professional | None | $93.33 | $141.25 | $436.52 |
Hometown Health Setting Facility Modifier None Typical Low $363.08 Median $363.08 Typical High $363.08 | Facility | None | $363.08 | $363.08 | $363.08 |
Hometown Health Setting Professional Modifier None Typical Low $0.72 Median $123.03 Typical High $537.03 | Professional | None | $0.72 | $123.03 | $537.03 |
Select Health Setting Facility Modifier None Typical Low $81.28 Median $134.90 Typical High $4,265.80 | Facility | None | $81.28 | $134.90 | $4,265.80 |
Select Health Setting Professional Modifier None Typical Low $120.23 Median $120.23 Typical High $120.23 | Professional | None | $120.23 | $120.23 | $120.23 |
United Setting Facility Modifier None Typical Low $302.00 Median $512.86 Typical High $2,137.96 | Facility | None | $302.00 | $512.86 | $2,137.96 |
United Setting Professional Modifier None Typical Low $85.11 Median $128.82 Typical High $190.55 | Professional | None | $85.11 | $128.82 | $190.55 |
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 $46.77 Median $66.07 Typical High $69.18 | Professional | 52 · Reduced service | $46.77 | $66.07 | $69.18 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $18.62 Median $26.30 Typical High $27.54 | Professional | 53 · Discontinued | $18.62 | $26.30 | $27.54 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $70.79 Median $97.72 Typical High $102.33 | Professional | 54 · Surgery only | $70.79 | $97.72 | $102.33 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $14.13 Median $19.50 Typical High $20.42 | Professional | 55 · Aftercare only | $14.13 | $19.50 | $20.42 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $9.33 Median $13.18 Typical High $13.80 | Professional | 56 · Pre-op care only | $9.33 | $13.18 | $13.80 |
Where Nevada sits
The same service costs 3.5 times more in Alaska than in Indiana. 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
$138
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.