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 $234.42 Median $2,238.72 Typical High $5,011.87 | Facility | None | $234.42 | $2,238.72 | $5,011.87 |
Aetna Setting Professional Modifier None Typical Low $229.09 Median $1,071.52 Typical High $1,318.26 | Professional | None | $229.09 | $1,071.52 | $1,318.26 |
Ambetter Setting Professional Modifier None Typical Low $954.99 Median $954.99 Typical High $954.99 | Professional | None | $954.99 | $954.99 | $954.99 |
Anthem BCBS Setting Professional Modifier None Typical Low $204.17 Median $912.01 Typical High $1,819.70 | Professional | None | $204.17 | $912.01 | $1,819.70 |
Cigna Setting Professional Modifier None Typical Low $208.93 Median $398.11 Typical High $1,698.24 | Professional | None | $208.93 | $398.11 | $1,698.24 |
Hometown Health Setting Professional Modifier None Typical Low $204.17 Median $380.19 Typical High $1,659.59 | Professional | None | $204.17 | $380.19 | $1,659.59 |
Hometown Health Setting Professional Modifier None Typical Low $3.72 Median $275.42 Typical High $1,584.89 | Professional | None | $3.72 | $275.42 | $1,584.89 |
Select Health Setting Facility Modifier None Typical Low $186.21 Median $1,071.52 Typical High $4,265.80 | Facility | None | $186.21 | $1,071.52 | $4,265.80 |
Select Health Setting Professional Modifier None Typical Low $141.25 Median $141.25 Typical High $186.21 | Professional | None | $141.25 | $141.25 | $186.21 |
United Setting Facility Modifier None Typical Low $251.19 Median $1,412.54 Typical High $1,995.26 | Facility | None | $251.19 | $1,412.54 | $1,995.26 |
United Setting Professional Modifier None Typical Low $218.78 Median $851.14 Typical High $1,621.81 | Professional | None | $218.78 | $851.14 | $1,621.81 |
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 $114.82 Median $323.59 Typical High $588.84 | Professional | 52 · Reduced service | $114.82 | $323.59 | $588.84 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $45.71 Median $128.82 Typical High $234.42 | Professional | 53 · Discontinued | $45.71 | $128.82 | $234.42 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $173.78 Median $489.78 Typical High $870.96 | Professional | 54 · Surgery only | $173.78 | $489.78 | $870.96 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $34.67 Median $97.72 Typical High $173.78 | Professional | 55 · Aftercare only | $34.67 | $97.72 | $173.78 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $22.91 Median $64.57 Typical High $117.49 | Professional | 56 · Pre-op care only | $22.91 | $64.57 | $117.49 |
Where Nevada sits
The same service costs 4.1 times more in Washington than in Nebraska. 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· 27th of 51
$912
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.