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 $158.49 Median $2,570.40 Typical High $6,165.95 | Facility | None | $158.49 | $2,570.40 | $6,165.95 |
Aetna Setting Professional Modifier None Typical Low $154.88 Median $158.49 Typical High $2,818.38 | Professional | None | $154.88 | $158.49 | $2,818.38 |
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 $138.04 Median $165.96 Typical High $288.40 | Professional | None | $138.04 | $165.96 | $288.40 |
Cigna Setting Facility Modifier None Typical Low $616.60 Median $3,311.31 Typical High $4,786.30 | Facility | None | $616.60 | $3,311.31 | $4,786.30 |
Cigna Setting Professional Modifier None Typical Low $131.83 Median $144.54 Typical High $263.03 | Professional | None | $131.83 | $144.54 | $263.03 |
Hometown Health Setting Professional Modifier None Typical Low $1.41 Median $162.18 Typical High $208.93 | Professional | None | $1.41 | $162.18 | $208.93 |
Hometown Health Setting Facility Modifier None Typical Low $3,311.31 Median $3,311.31 Typical High $3,311.31 | Facility | None | $3,311.31 | $3,311.31 | $3,311.31 |
Hometown Health Setting Professional Modifier None Typical Low $1.20 Median $1.20 Typical High $181.97 | Professional | None | $1.20 | $1.20 | $181.97 |
Select Health Setting Facility Modifier None Typical Low $120.23 Median $120.23 Typical High $4,265.80 | Facility | None | $120.23 | $120.23 | $4,265.80 |
United Setting Facility Modifier None Typical Low $1,905.46 Median $3,019.95 Typical High $10,000.00 | Facility | None | $1,905.46 | $3,019.95 | $10,000.00 |
United Setting Professional Modifier None Typical Low $102.33 Median $162.18 Typical High $263.03 | Professional | None | $102.33 | $162.18 | $263.03 |
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 $77.62 Median $79.43 Typical High $79.43 | Professional | 52 · Reduced service | $77.62 | $79.43 | $79.43 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $30.90 Median $31.62 Typical High $31.62 | Professional | 53 · Discontinued | $30.90 | $31.62 | $31.62 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $117.49 Median $117.49 Typical High $117.49 | Professional | 54 · Surgery only | $117.49 | $117.49 | $117.49 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $23.44 Median $23.44 Typical High $23.44 | Professional | 55 · Aftercare only | $23.44 | $23.44 | $23.44 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $15.49 Median $15.85 Typical High $15.85 | Professional | 56 · Pre-op care only | $15.49 | $15.85 | $15.85 |
Where Nevada sits
The same service costs 20.4 times more in Kansas 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· 26th of 51
$288
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.