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 $275.42 Median $1,698.24 Typical High $4,365.16 | Facility | None | $275.42 | $1,698.24 | $4,365.16 |
Aetna Setting Professional Modifier None Typical Low $275.42 Median $1,096.48 Typical High $1,445.44 | Professional | None | $275.42 | $1,096.48 | $1,445.44 |
Ambetter Setting Professional Modifier None Typical Low $229.09 Median $229.09 Typical High $229.09 | Professional | None | $229.09 | $229.09 | $229.09 |
Anthem BCBS Setting Professional Modifier None Typical Low $239.88 Median $1,096.48 Typical High $2,137.96 | Professional | None | $239.88 | $1,096.48 | $2,137.96 |
Cigna Setting Professional Modifier None Typical Low $186.21 Median $1,023.29 Typical High $1,995.26 | Professional | None | $186.21 | $1,023.29 | $1,995.26 |
Hometown Health Setting Professional Modifier None Typical Low $186.21 Median $416.87 Typical High $2,290.87 | Professional | None | $186.21 | $416.87 | $2,290.87 |
Hometown Health Setting Professional Modifier None Typical Low $2.69 Median $323.59 Typical High $2,290.87 | Professional | None | $2.69 | $323.59 | $2,290.87 |
Select Health Setting Facility Modifier None Typical Low $218.78 Median $1,548.82 Typical High $4,265.80 | Facility | None | $218.78 | $1,548.82 | $4,265.80 |
Select Health Setting Professional Modifier None Typical Low $165.96 Median $165.96 Typical High $218.78 | Professional | None | $165.96 | $165.96 | $218.78 |
United Setting Facility Modifier None Typical Low $251.19 Median $1,412.54 Typical High $2,041.74 | Facility | None | $251.19 | $1,412.54 | $2,041.74 |
United Setting Professional Modifier None Typical Low $245.47 Median $1,258.93 Typical High $1,995.26 | Professional | None | $245.47 | $1,258.93 | $1,995.26 |
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 $134.90 Median $354.81 Typical High $707.95 | Professional | 52 · Reduced service | $134.90 | $354.81 | $707.95 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $54.95 Median $141.25 Typical High $281.84 | Professional | 53 · Discontinued | $54.95 | $141.25 | $281.84 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $204.17 Median $537.03 Typical High $1,047.13 | Professional | 54 · Surgery only | $204.17 | $537.03 | $1,047.13 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $40.74 Median $107.15 Typical High $208.93 | Professional | 55 · Aftercare only | $40.74 | $107.15 | $208.93 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $27.54 Median $70.79 Typical High $141.25 | Professional | 56 · Pre-op care only | $27.54 | $70.79 | $141.25 |
Anthem BCBS Setting Professional Modifier 50 · Both sides Typical Low $331.13 Median $1,659.59 Typical High $2,187.76 | Professional | 50 · Both sides | $331.13 | $1,659.59 | $2,187.76 |
Where Nevada sits
The same service costs 6.5 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· 34th of 51
$1,096
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.