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 $141.25 Median $1,698.24 Typical High $4,466.84 | Facility | None | $141.25 | $1,698.24 | $4,466.84 |
Aetna Setting Professional Modifier None Typical Low $141.25 Median $141.25 Typical High $141.25 | Professional | None | $141.25 | $141.25 | $141.25 |
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 $123.03 Median $141.25 Typical High $229.09 | Professional | None | $123.03 | $141.25 | $229.09 |
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 $95.50 Median $117.49 Typical High $173.78 | Professional | None | $95.50 | $117.49 | $173.78 |
Hometown Health Setting Professional Modifier None Typical Low $7.94 Median $109.65 Typical High $158.49 | Professional | None | $7.94 | $109.65 | $158.49 |
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 $6.03 Median $6.03 Typical High $165.96 | Professional | None | $6.03 | $6.03 | $165.96 |
Select Health Setting Facility Modifier None Typical Low $112.20 Median $112.20 Typical High $4,265.80 | Facility | None | $112.20 | $112.20 | $4,265.80 |
Select Health Setting Professional Modifier None Typical Low $75.86 Median $100.00 Typical High $218.78 | Professional | None | $75.86 | $100.00 | $218.78 |
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 $107.15 Median $131.83 Typical High $177.83 | Professional | None | $107.15 | $131.83 | $177.83 |
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 $70.79 Median $70.79 Typical High $70.79 | Professional | 52 · Reduced service | $70.79 | $70.79 | $70.79 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $28.18 Median $28.18 Typical High $28.18 | Professional | 53 · Discontinued | $28.18 | $28.18 | $28.18 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $104.71 Median $107.15 Typical High $107.15 | Professional | 54 · Surgery only | $104.71 | $107.15 | $107.15 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $20.89 Median $21.38 Typical High $21.38 | Professional | 55 · Aftercare only | $20.89 | $21.38 | $21.38 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $14.13 Median $14.13 Typical High $14.13 | Professional | 56 · Pre-op care only | $14.13 | $14.13 | $14.13 |
Where Nevada sits
The same service costs 5.1 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· 39th of 51
$141
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.