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 $54.95 Median $1,698.24 Typical High $4,466.84 | Facility | None | $54.95 | $1,698.24 | $4,466.84 |
Aetna Setting Professional Modifier None Typical Low $54.95 Median $54.95 Typical High $54.95 | Professional | None | $54.95 | $54.95 | $54.95 |
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 $50.12 Median $56.23 Typical High $93.33 | Professional | None | $50.12 | $56.23 | $93.33 |
Cigna Setting Facility Modifier None Typical Low $257.04 Median $316.23 Typical High $602.56 | Facility | None | $257.04 | $316.23 | $602.56 |
Cigna Setting Professional Modifier None Typical Low $47.86 Median $47.86 Typical High $74.13 | Professional | None | $47.86 | $47.86 | $74.13 |
Hometown Health Setting Professional Modifier None Typical Low $0.95 Median $50.12 Typical High $67.61 | Professional | None | $0.95 | $50.12 | $67.61 |
Hometown Health Setting Facility Modifier None Typical Low $257.04 Median $257.04 Typical High $257.04 | Facility | None | $257.04 | $257.04 | $257.04 |
Hometown Health Setting Professional Modifier None Typical Low $0.72 Median $0.72 Typical High $63.10 | Professional | None | $0.72 | $0.72 | $63.10 |
Select Health Setting Facility Modifier None Typical Low $41.69 Median $41.69 Typical High $4,265.80 | Facility | None | $41.69 | $41.69 | $4,265.80 |
Select Health Setting Professional Modifier None Typical Low $30.20 Median $37.15 Typical High $81.28 | Professional | None | $30.20 | $37.15 | $81.28 |
United Setting Facility Modifier None Typical Low $97.72 Median $234.42 Typical High $1,949.84 | Facility | None | $97.72 | $234.42 | $1,949.84 |
United Setting Professional Modifier None Typical Low $41.69 Median $52.48 Typical High $72.44 | Professional | None | $41.69 | $52.48 | $72.44 |
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 $27.54 Median $27.54 Typical High $27.54 | Professional | 52 · Reduced service | $27.54 | $27.54 | $27.54 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $10.96 Median $10.96 Typical High $10.96 | Professional | 53 · Discontinued | $10.96 | $10.96 | $10.96 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $40.74 Median $41.69 Typical High $41.69 | Professional | 54 · Surgery only | $40.74 | $41.69 | $41.69 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $8.13 Median $8.32 Typical High $8.32 | Professional | 55 · Aftercare only | $8.13 | $8.32 | $8.32 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $5.50 Median $5.50 Typical High $5.50 | Professional | 56 · Pre-op care only | $5.50 | $5.50 | $5.50 |
Where Nevada sits
The same service costs 4.2 times more in Alaska than in Florida. 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
$54.95
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.