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 $131.83 Median $1,698.24 Typical High $4,466.84 | Facility | None | $131.83 | $1,698.24 | $4,466.84 |
Aetna Setting Professional Modifier None Typical Low $131.83 Median $131.83 Typical High $131.83 | Professional | None | $131.83 | $131.83 | $131.83 |
Anthem BCBS Setting Facility Modifier None Typical Low $2,570.40 Median $3,801.89 Typical High $5,128.61 | Facility | None | $2,570.40 | $3,801.89 | $5,128.61 |
Anthem BCBS Setting Professional Modifier None Typical Low $123.03 Median $138.04 Typical High $229.09 | Professional | None | $123.03 | $138.04 | $229.09 |
Cigna Setting Facility Modifier None Typical Low $660.69 Median $758.58 Typical High $1,122.02 | Facility | None | $660.69 | $758.58 | $1,122.02 |
Cigna Setting Professional Modifier None Typical Low $107.15 Median $107.15 Typical High $181.97 | Professional | None | $107.15 | $107.15 | $181.97 |
Hometown Health Setting Professional Modifier None Typical Low $0.42 Median $0.48 Typical High $1.32 | Professional | None | $0.42 | $0.48 | $1.32 |
Hometown Health Setting Facility Modifier None Typical Low $691.83 Median $691.83 Typical High $691.83 | Facility | None | $691.83 | $691.83 | $691.83 |
Hometown Health Setting Professional Modifier None Typical Low $0.36 Median $0.36 Typical High $0.36 | Professional | None | $0.36 | $0.36 | $0.36 |
Select Health Setting Facility Modifier None Typical Low $4,265.80 Median $4,265.80 Typical High $4,265.80 | Facility | None | $4,265.80 | $4,265.80 | $4,265.80 |
Select Health Setting Professional Modifier None Typical Low $870.96 Median $5,011.87 Typical High $5,128.61 | Professional | None | $870.96 | $5,011.87 | $5,128.61 |
United Setting Facility Modifier None Typical Low $467.74 Median $724.44 Typical High $2,884.03 | Facility | None | $467.74 | $724.44 | $2,884.03 |
United Setting Professional Modifier None Typical Low $102.33 Median $120.23 Typical High $158.49 | Professional | None | $102.33 | $120.23 | $158.49 |
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 $66.07 Median $66.07 Typical High $66.07 | Professional | 52 · Reduced service | $66.07 | $66.07 | $66.07 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $26.30 Median $26.30 Typical High $26.30 | Professional | 53 · Discontinued | $26.30 | $26.30 | $26.30 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $100.00 Median $100.00 Typical High $100.00 | Professional | 54 · Surgery only | $100.00 | $100.00 | $100.00 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $19.95 Median $19.95 Typical High $19.95 | Professional | 55 · Aftercare only | $19.95 | $19.95 | $19.95 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $13.18 Median $13.18 Typical High $13.18 | Professional | 56 · Pre-op care only | $13.18 | $13.18 | $13.18 |
Where Nevada sits
The same service costs 6.0 times more in Alaska than in Kentucky. 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
$132
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.