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 $407.38 Median $2,570.40 Typical High $5,011.87 | Facility | None | $407.38 | $2,570.40 | $5,011.87 |
Aetna Setting Professional Modifier None Typical Low $398.11 Median $1,584.89 Typical High $2,398.83 | Professional | None | $398.11 | $1,584.89 | $2,398.83 |
Ambetter Setting Professional Modifier None Typical Low $147.91 Median $147.91 Typical High $239.88 | Professional | None | $147.91 | $147.91 | $239.88 |
Anthem BCBS Setting Facility Modifier None Typical Low $2,951.21 Median $4,677.35 Typical High $6,165.95 | Facility | None | $2,951.21 | $4,677.35 | $6,165.95 |
Anthem BCBS Setting Professional Modifier None Typical Low $354.81 Median $1,698.24 Typical High $3,388.44 | Professional | None | $354.81 | $1,698.24 | $3,388.44 |
Cigna Setting Professional Modifier None Typical Low $288.40 Median $1,479.11 Typical High $2,951.21 | Professional | None | $288.40 | $1,479.11 | $2,951.21 |
Hometown Health Setting Professional Modifier None Typical Low $288.40 Median $630.96 Typical High $3,388.44 | Professional | None | $288.40 | $630.96 | $3,388.44 |
Hometown Health Setting Professional Modifier None Typical Low $4.17 Median $478.63 Typical High $3,388.44 | Professional | None | $4.17 | $478.63 | $3,388.44 |
Select Health Setting Facility Modifier None Typical Low $316.23 Median $2,290.87 Typical High $4,265.80 | Facility | None | $316.23 | $2,290.87 | $4,265.80 |
Select Health Setting Professional Modifier None Typical Low $245.47 Median $245.47 Typical High $316.23 | Professional | None | $245.47 | $245.47 | $316.23 |
United Setting Facility Modifier None Typical Low $3,019.95 Median $6,165.95 Typical High $11,481.54 | Facility | None | $3,019.95 | $6,165.95 | $11,481.54 |
United Setting Professional Modifier None Typical Low $371.54 Median $1,862.09 Typical High $2,951.21 | Professional | None | $371.54 | $1,862.09 | $2,951.21 |
6 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 $199.53 Median $524.81 Typical High $1,096.48 | Professional | 52 · Reduced service | $199.53 | $524.81 | $1,096.48 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $81.28 Median $208.93 Typical High $436.52 | Professional | 53 · Discontinued | $81.28 | $208.93 | $436.52 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $302.00 Median $794.33 Typical High $1,621.81 | Professional | 54 · Surgery only | $302.00 | $794.33 | $1,621.81 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $60.26 Median $158.49 Typical High $323.59 | Professional | 55 · Aftercare only | $60.26 | $158.49 | $323.59 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $39.81 Median $104.71 Typical High $218.78 | Professional | 56 · Pre-op care only | $39.81 | $104.71 | $218.78 |
Anthem BCBS Setting Professional Modifier 50 · Both sides Typical Low $489.78 Median $2,570.40 Typical High $3,388.44 | Professional | 50 · Both sides | $489.78 | $2,570.40 | $3,388.44 |
Where Nevada sits
The same service costs 6.2 times more in Washington 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· 32nd of 51
$1,698
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.