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 $426.58 Median $3,981.07 Typical High $8,128.31 | Facility | None | $426.58 | $3,981.07 | $8,128.31 |
Aetna Setting Professional Modifier None Typical Low $426.58 Median $426.58 Typical High $426.58 | Professional | None | $426.58 | $426.58 | $426.58 |
Anthem BCBS Setting Facility Modifier None Typical Low $2,951.21 Median $4,677.35 Typical High $6,165.95 | Facility | None | $2,951.21 | $4,677.35 | $6,165.95 |
Anthem BCBS Setting Professional Modifier None Typical Low $398.11 Median $457.09 Typical High $741.31 | Professional | None | $398.11 | $457.09 | $741.31 |
Cigna Setting Facility Modifier None Typical Low $1,412.54 Median $5,011.87 Typical High $6,918.31 | Facility | None | $1,412.54 | $5,011.87 | $6,918.31 |
Cigna Setting Professional Modifier None Typical Low $309.03 Median $371.54 Typical High $575.44 | Professional | None | $309.03 | $371.54 | $575.44 |
Hometown Health Setting Professional Modifier None Typical Low $6.46 Median $389.05 Typical High $549.54 | Professional | None | $6.46 | $389.05 | $549.54 |
Hometown Health Setting Facility Modifier None Typical Low $4,786.30 Median $4,786.30 Typical High $4,786.30 | Facility | None | $4,786.30 | $4,786.30 | $4,786.30 |
Hometown Health Setting Professional Modifier None Typical Low $4.79 Median $4.79 Typical High $537.03 | Professional | None | $4.79 | $4.79 | $537.03 |
Select Health Setting Facility Modifier None Typical Low $354.81 Median $354.81 Typical High $4,265.80 | Facility | None | $354.81 | $354.81 | $4,265.80 |
Select Health Setting Professional Modifier None Typical Low $251.19 Median $323.59 Typical High $741.31 | Professional | None | $251.19 | $323.59 | $741.31 |
United Setting Facility Modifier None Typical Low $1,174.90 Median $1,698.24 Typical High $4,073.80 | Facility | None | $1,174.90 | $1,698.24 | $4,073.80 |
United Setting Professional Modifier None Typical Low $354.81 Median $416.87 Typical High $549.54 | Professional | None | $354.81 | $416.87 | $549.54 |
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 $213.80 Median $213.80 Typical High $213.80 | Professional | 52 · Reduced service | $213.80 | $213.80 | $213.80 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $85.11 Median $85.11 Typical High $85.11 | Professional | 53 · Discontinued | $85.11 | $85.11 | $85.11 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $316.23 Median $316.23 Typical High $316.23 | Professional | 54 · Surgery only | $316.23 | $316.23 | $316.23 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $64.57 Median $64.57 Typical High $64.57 | Professional | 55 · Aftercare only | $64.57 | $64.57 | $64.57 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $42.66 Median $42.66 Typical High $42.66 | Professional | 56 · Pre-op care only | $42.66 | $42.66 | $42.66 |
Where Nevada sits
The same service costs 4.5 times more in Alaska than in Texas. 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
$427
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.