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 $186.21 Median $1,698.24 Typical High $4,466.84 | Facility | None | $186.21 | $1,698.24 | $4,466.84 |
Aetna Setting Professional Modifier None Typical Low $186.21 Median $186.21 Typical High $186.21 | Professional | None | $186.21 | $186.21 | $186.21 |
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 $165.96 Median $190.55 Typical High $316.23 | Professional | None | $165.96 | $190.55 | $316.23 |
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 $89.13 Median $104.71 Typical High $204.17 | Professional | None | $89.13 | $104.71 | $204.17 |
Hometown Health Setting Professional Modifier None Typical Low $5.62 Median $104.71 Typical High $199.53 | Professional | None | $5.62 | $104.71 | $199.53 |
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 $4.17 Median $4.17 Typical High $213.80 | Professional | None | $4.17 | $4.17 | $213.80 |
Select Health Setting Facility Modifier None Typical Low $141.25 Median $141.25 Typical High $4,265.80 | Facility | None | $141.25 | $141.25 | $4,265.80 |
Select Health Setting Professional Modifier None Typical Low $104.71 Median $128.82 Typical High $281.84 | Professional | None | $104.71 | $128.82 | $281.84 |
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 $112.20 Median $141.25 Typical High $204.17 | Professional | None | $112.20 | $141.25 | $204.17 |
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 $93.33 Median $93.33 Typical High $93.33 | Professional | 52 · Reduced service | $93.33 | $93.33 | $93.33 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $37.15 Median $37.15 Typical High $37.15 | Professional | 53 · Discontinued | $37.15 | $37.15 | $37.15 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $138.04 Median $141.25 Typical High $141.25 | Professional | 54 · Surgery only | $138.04 | $141.25 | $141.25 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $27.54 Median $28.18 Typical High $28.18 | Professional | 55 · Aftercare only | $27.54 | $28.18 | $28.18 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $18.62 Median $18.62 Typical High $18.62 | Professional | 56 · Pre-op care only | $18.62 | $18.62 | $18.62 |
Where Nevada sits
The same service costs 4.6 times more in Alaska than in Utah. 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· 40th of 51
$174
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.