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 $114.82 Median $2,238.72 Typical High $5,128.61 | Facility | None | $114.82 | $2,238.72 | $5,128.61 |
Aetna Setting Professional Modifier None Typical Low $114.82 Median $114.82 Typical High $114.82 | Professional | None | $114.82 | $114.82 | $114.82 |
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 $104.71 Median $117.49 Typical High $190.55 | Professional | None | $104.71 | $117.49 | $190.55 |
Cigna Setting Facility Modifier None Typical Low $257.04 Median $316.23 Typical High $912.01 | Facility | None | $257.04 | $316.23 | $912.01 |
Cigna Setting Professional Modifier None Typical Low $77.62 Median $85.11 Typical High $138.04 | Professional | None | $77.62 | $85.11 | $138.04 |
Hometown Health Setting Professional Modifier None Typical Low $1.05 Median $89.13 Typical High $128.82 | Professional | None | $1.05 | $89.13 | $128.82 |
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 $0.78 Median $0.78 Typical High $131.83 | Professional | None | $0.78 | $0.78 | $131.83 |
Select Health Setting Facility Modifier None Typical Low $87.10 Median $87.10 Typical High $4,265.80 | Facility | None | $87.10 | $87.10 | $4,265.80 |
Select Health Setting Professional Modifier None Typical Low $66.07 Median $79.43 Typical High $169.82 | Professional | None | $66.07 | $79.43 | $169.82 |
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 $75.86 Median $100.00 Typical High $131.83 | Professional | None | $75.86 | $100.00 | $131.83 |
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 $57.54 Median $57.54 Typical High $57.54 | Professional | 52 · Reduced service | $57.54 | $57.54 | $57.54 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $22.91 Median $23.44 Typical High $23.44 | Professional | 53 · Discontinued | $22.91 | $23.44 | $23.44 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $87.10 Median $87.10 Typical High $87.10 | Professional | 54 · Surgery only | $87.10 | $87.10 | $87.10 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $17.38 Median $17.38 Typical High $17.38 | Professional | 55 · Aftercare only | $17.38 | $17.38 | $17.38 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $11.48 Median $11.48 Typical High $11.48 | Professional | 56 · Pre-op care only | $11.48 | $11.48 | $11.48 |
Where Nevada sits
The same service costs 4.8 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· 42nd of 51
$110
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.