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 $234.42 Median $1,698.24 Typical High $4,365.16 | Facility | None | $234.42 | $1,698.24 | $4,365.16 |
Aetna Setting Professional Modifier None Typical Low $107.15 Median $173.78 Typical High $234.42 | Professional | None | $107.15 | $173.78 | $234.42 |
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 $100.00 Median $199.53 Typical High $316.23 | Professional | None | $100.00 | $199.53 | $316.23 |
Cigna Setting Facility Modifier None Typical Low $398.11 Median $1,513.56 Typical High $2,137.96 | Facility | None | $398.11 | $1,513.56 | $2,137.96 |
Cigna Setting Professional Modifier None Typical Low $87.10 Median $128.82 Typical High $245.47 | Professional | None | $87.10 | $128.82 | $245.47 |
Hometown Health Setting Professional Modifier None Typical Low $83.18 Median $190.55 Typical High $407.38 | Professional | None | $83.18 | $190.55 | $407.38 |
Hometown Health Setting Facility Modifier None Typical Low $1,479.11 Median $1,479.11 Typical High $1,479.11 | Facility | None | $1,479.11 | $1,479.11 | $1,479.11 |
Hometown Health Setting Professional Modifier None Typical Low $1.51 Median $141.25 Typical High $2,238.72 | Professional | None | $1.51 | $141.25 | $2,238.72 |
Select Health Setting Facility Modifier None Typical Low $93.33 Median $234.42 Typical High $4,265.80 | Facility | None | $93.33 | $234.42 | $4,265.80 |
Select Health Setting Professional Modifier None Typical Low $79.43 Median $114.82 Typical High $234.42 | Professional | None | $79.43 | $114.82 | $234.42 |
United Setting Facility Modifier None Typical Low $954.99 Median $1,318.26 Typical High $3,311.31 | Facility | None | $954.99 | $1,318.26 | $3,311.31 |
United Setting Professional Modifier None Typical Low $87.10 Median $169.82 Typical High $269.15 | Professional | None | $87.10 | $169.82 | $269.15 |
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 $53.70 Median $79.43 Typical High $117.49 | Professional | 52 · Reduced service | $53.70 | $79.43 | $117.49 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $21.88 Median $31.62 Typical High $46.77 | Professional | 53 · Discontinued | $21.88 | $31.62 | $46.77 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $81.28 Median $117.49 Typical High $173.78 | Professional | 54 · Surgery only | $81.28 | $117.49 | $173.78 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $16.22 Median $23.44 Typical High $34.67 | Professional | 55 · Aftercare only | $16.22 | $23.44 | $34.67 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $10.72 Median $15.85 Typical High $23.44 | Professional | 56 · Pre-op care only | $10.72 | $15.85 | $23.44 |
Where Nevada sits
The same service costs 4.0 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· 37th of 51
$182
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.