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 $93.33 Median $1,698.24 Typical High $4,365.16 | Facility | None | $93.33 | $1,698.24 | $4,365.16 |
Aetna Setting Professional Modifier None Typical Low $91.20 Median $208.93 Typical High $316.23 | Professional | None | $91.20 | $208.93 | $316.23 |
Anthem BCBS Setting Facility Modifier None Typical Low $3,235.94 Median $6,760.83 Typical High $12,589.25 | Facility | None | $3,235.94 | $6,760.83 | $12,589.25 |
Anthem BCBS Setting Professional Modifier None Typical Low $87.10 Median $190.55 Typical High $331.13 | Professional | None | $87.10 | $190.55 | $331.13 |
Cigna Setting Facility Modifier None Typical Low $398.11 Median $1,778.28 Typical High $2,454.71 | Facility | None | $398.11 | $1,778.28 | $2,454.71 |
Cigna Setting Professional Modifier None Typical Low $100.00 Median $229.09 Typical High $354.81 | Professional | None | $100.00 | $229.09 | $354.81 |
Hometown Health Setting Professional Modifier None Typical Low $102.33 Median $263.03 Typical High $2,137.96 | Professional | None | $102.33 | $263.03 | $2,137.96 |
Hometown Health Setting Facility Modifier None Typical Low $1,698.24 Median $1,698.24 Typical High $1,698.24 | Facility | None | $1,698.24 | $1,698.24 | $1,698.24 |
Hometown Health Setting Professional Modifier None Typical Low $3.02 Median $117.49 Typical High $2,570.40 | Professional | None | $3.02 | $117.49 | $2,570.40 |
Select Health Setting Facility Modifier None Typical Low $77.62 Median $213.80 Typical High $4,265.80 | Facility | None | $77.62 | $213.80 | $4,265.80 |
United Setting Facility Modifier None Typical Low $302.00 Median $512.86 Typical High $3,019.95 | Facility | None | $302.00 | $512.86 | $3,019.95 |
United Setting Professional Modifier None Typical Low $97.72 Median $213.80 Typical High $346.74 | Professional | None | $97.72 | $213.80 | $346.74 |
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 $45.71 Median $61.66 Typical High $104.71 | Professional | 52 · Reduced service | $45.71 | $61.66 | $104.71 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $18.20 Median $24.55 Typical High $42.66 | Professional | 53 · Discontinued | $18.20 | $24.55 | $42.66 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $69.18 Median $93.33 Typical High $158.49 | Professional | 54 · Surgery only | $69.18 | $93.33 | $158.49 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $13.80 Median $18.62 Typical High $31.62 | Professional | 55 · Aftercare only | $13.80 | $18.62 | $31.62 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $9.12 Median $12.30 Typical High $20.89 | Professional | 56 · Pre-op care only | $9.12 | $12.30 | $20.89 |
Where Nevada sits
The same service costs 4.1 times more in Alaska than in Nebraska. 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· 24th of 51
$275
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.