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 $169.82 Median $1,698.24 Typical High $4,365.16 | Facility | None | $169.82 | $1,698.24 | $4,365.16 |
Aetna Setting Professional Modifier None Typical Low $165.96 Median $1,862.09 Typical High $2,089.30 | Professional | None | $165.96 | $1,862.09 | $2,089.30 |
Anthem BCBS Setting Facility Modifier None Typical Low $19,952.62 Median $19,952.62 Typical High $25,118.86 | Facility | None | $19,952.62 | $19,952.62 | $25,118.86 |
Anthem BCBS Setting Professional Modifier None Typical Low $154.88 Median $1,737.80 Typical High $3,090.30 | Professional | None | $154.88 | $1,737.80 | $3,090.30 |
Cigna Setting Facility Modifier None Typical Low $562.34 Median $758.58 Typical High $2,137.96 | Facility | None | $562.34 | $758.58 | $2,137.96 |
Cigna Setting Professional Modifier None Typical Low $123.03 Median $1,659.59 Typical High $2,454.71 | Professional | None | $123.03 | $1,659.59 | $2,454.71 |
Hometown Health Setting Professional Modifier None Typical Low $154.88 Median $1,479.11 Typical High $2,818.38 | Professional | None | $154.88 | $1,479.11 | $2,818.38 |
Hometown Health Setting Professional Modifier None Typical Low $2.40 Median $190.55 Typical High $2,511.89 | Professional | None | $2.40 | $190.55 | $2,511.89 |
Select Health Setting Facility Modifier None Typical Low $128.82 Median $1,659.59 Typical High $4,265.80 | Facility | None | $128.82 | $1,659.59 | $4,265.80 |
United Setting Facility Modifier None Typical Low $1,905.46 Median $3,019.95 Typical High $11,481.54 | Facility | None | $1,905.46 | $3,019.95 | $11,481.54 |
United Setting Professional Modifier None Typical Low $162.18 Median $1,698.24 Typical High $2,951.21 | Professional | None | $162.18 | $1,698.24 | $2,951.21 |
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 $83.18 Median $91.20 Typical High $977.24 | Professional | 52 · Reduced service | $83.18 | $91.20 | $977.24 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $33.11 Median $36.31 Typical High $389.05 | Professional | 53 · Discontinued | $33.11 | $36.31 | $389.05 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $125.89 Median $138.04 Typical High $1,445.44 | Professional | 54 · Surgery only | $125.89 | $138.04 | $1,445.44 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $25.12 Median $27.54 Typical High $288.40 | Professional | 55 · Aftercare only | $25.12 | $27.54 | $288.40 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $16.60 Median $18.20 Typical High $194.98 | Professional | 56 · Pre-op care only | $16.60 | $18.20 | $194.98 |
Where Nevada sits
The same service costs 11.2 times more in Oklahoma than in Hawaii. 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· 29th of 51
$1,778
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.