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 $141.25 Median $1,698.24 Typical High $4,466.84 | Facility | None | $141.25 | $1,698.24 | $4,466.84 |
Aetna Setting Professional Modifier None Typical Low $141.25 Median $141.25 Typical High $141.25 | Professional | None | $141.25 | $141.25 | $141.25 |
Anthem BCBS Setting Facility Modifier None Typical Low $1,096.48 Median $3,801.89 Typical High $5,128.61 | Facility | None | $1,096.48 | $3,801.89 | $5,128.61 |
Anthem BCBS Setting Professional Modifier None Typical Low $131.83 Median $147.91 Typical High $245.47 | Professional | None | $131.83 | $147.91 | $245.47 |
Cigna Setting Facility Modifier None Typical Low $407.38 Median $977.24 Typical High $1,412.54 | Facility | None | $407.38 | $977.24 | $1,412.54 |
Cigna Setting Professional Modifier None Typical Low $147.91 Median $186.21 Typical High $263.03 | Professional | None | $147.91 | $186.21 | $263.03 |
Hometown Health Setting Professional Modifier None Typical Low $4.57 Median $177.83 Typical High $251.19 | Professional | None | $4.57 | $177.83 | $251.19 |
Hometown Health Setting Facility Modifier None Typical Low $933.25 Median $933.25 Typical High $933.25 | Facility | None | $933.25 | $933.25 | $933.25 |
Hometown Health Setting Professional Modifier None Typical Low $3.39 Median $3.39 Typical High $177.83 | Professional | None | $3.39 | $3.39 | $177.83 |
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 |
Select Health Setting Professional Modifier None Typical Low $83.18 Median $109.65 Typical High $309.03 | Professional | None | $83.18 | $109.65 | $309.03 |
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 $120.23 Median $165.96 Typical High $295.12 | Professional | None | $120.23 | $165.96 | $295.12 |
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 $69.18 Median $69.18 Typical High $69.18 | Professional | 52 · Reduced service | $69.18 | $69.18 | $69.18 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $28.18 Median $28.18 Typical High $28.18 | Professional | 53 · Discontinued | $28.18 | $28.18 | $28.18 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $104.71 Median $104.71 Typical High $104.71 | Professional | 54 · Surgery only | $104.71 | $104.71 | $104.71 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $20.89 Median $20.89 Typical High $20.89 | Professional | 55 · Aftercare only | $20.89 | $20.89 | $20.89 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $14.13 Median $14.13 Typical High $14.13 | Professional | 56 · Pre-op care only | $14.13 | $14.13 | $14.13 |
Where Nevada sits
The same service costs 5.4 times more in Alaska than in Utah. 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· 41st of 51
$158
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.