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 $165.96 Median $1,698.24 Typical High $4,365.16 | Facility | None | $165.96 | $1,698.24 | $4,365.16 |
Aetna Setting Professional Modifier None Typical Low $165.96 Median $346.74 Typical High $457.09 | Professional | None | $165.96 | $346.74 | $457.09 |
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 $154.88 Median $371.54 Typical High $616.60 | Professional | None | $154.88 | $371.54 | $616.60 |
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 $144.54 Median $213.80 Typical High $478.63 | Professional | None | $144.54 | $213.80 | $478.63 |
Hometown Health Setting Professional Modifier None Typical Low $138.04 Median $316.23 Typical High $794.33 | Professional | None | $138.04 | $316.23 | $794.33 |
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 $2.63 Median $208.93 Typical High $1,412.54 | Professional | None | $2.63 | $208.93 | $1,412.54 |
Select Health Setting Facility Modifier None Typical Low $141.25 Median $467.74 Typical High $4,265.80 | Facility | None | $141.25 | $467.74 | $4,265.80 |
Select Health Setting Professional Modifier None Typical Low $120.23 Median $181.97 Typical High $467.74 | Professional | None | $120.23 | $181.97 | $467.74 |
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 $158.49 Median $331.13 Typical High $537.03 | Professional | None | $158.49 | $331.13 | $537.03 |
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 $83.18 Median $162.18 Typical High $223.87 | Professional | 52 · Reduced service | $83.18 | $162.18 | $223.87 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $33.11 Median $64.57 Typical High $91.20 | Professional | 53 · Discontinued | $33.11 | $64.57 | $91.20 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $125.89 Median $239.88 Typical High $338.84 | Professional | 54 · Surgery only | $125.89 | $239.88 | $338.84 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $25.12 Median $47.86 Typical High $67.61 | Professional | 55 · Aftercare only | $25.12 | $47.86 | $67.61 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $16.60 Median $32.36 Typical High $45.71 | Professional | 56 · Pre-op care only | $16.60 | $32.36 | $45.71 |
Where Nevada sits
The same service costs 4.5 times more in Alaska than in Washington, DC. 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· 40th of 51
$331
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.