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 $125.89 Median $1,698.24 Typical High $4,466.84 | Facility | None | $125.89 | $1,698.24 | $4,466.84 |
Aetna Setting Professional Modifier None Typical Low $123.03 Median $125.89 Typical High $3,801.89 | Professional | None | $123.03 | $125.89 | $3,801.89 |
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 $112.20 Median $134.90 Typical High $245.47 | Professional | None | $112.20 | $134.90 | $245.47 |
Cigna Setting Facility Modifier None Typical Low $398.11 Median $2,137.96 Typical High $3,090.30 | Facility | None | $398.11 | $2,137.96 | $3,090.30 |
Cigna Setting Professional Modifier None Typical Low $97.72 Median $109.65 Typical High $204.17 | Professional | None | $97.72 | $109.65 | $204.17 |
Hometown Health Setting Professional Modifier None Typical Low $0.98 Median $131.83 Typical High $173.78 | Professional | None | $0.98 | $131.83 | $173.78 |
Hometown Health Setting Facility Modifier None Typical Low $2,137.96 Median $2,137.96 Typical High $2,137.96 | Facility | None | $2,137.96 | $2,137.96 | $2,137.96 |
Hometown Health Setting Professional Modifier None Typical Low $0.83 Median $0.83 Typical High $151.36 | Professional | None | $0.83 | $0.83 | $151.36 |
Select Health Setting Facility Modifier None Typical Low $100.00 Median $100.00 Typical High $4,265.80 | Facility | None | $100.00 | $100.00 | $4,265.80 |
United Setting Facility Modifier None Typical Low $1,174.90 Median $1,698.24 Typical High $4,677.35 | Facility | None | $1,174.90 | $1,698.24 | $4,677.35 |
United Setting Professional Modifier None Typical Low $114.82 Median $158.49 Typical High $239.88 | Professional | None | $114.82 | $158.49 | $239.88 |
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 $61.66 Median $63.10 Typical High $63.10 | Professional | 52 · Reduced service | $61.66 | $63.10 | $63.10 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $24.55 Median $25.12 Typical High $25.12 | Professional | 53 · Discontinued | $24.55 | $25.12 | $25.12 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $93.33 Median $93.33 Typical High $93.33 | Professional | 54 · Surgery only | $93.33 | $93.33 | $93.33 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $18.62 Median $18.62 Typical High $18.62 | Professional | 55 · Aftercare only | $18.62 | $18.62 | $18.62 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $12.30 Median $12.59 Typical High $12.59 | Professional | 56 · Pre-op care only | $12.30 | $12.59 | $12.59 |
Where Nevada sits
The same service costs 12.9 times more in Arkansas than in New York. 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
$245
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.