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 $223.87 Median $1,698.24 Typical High $4,365.16 | Facility | None | $223.87 | $1,698.24 | $4,365.16 |
Aetna Setting Professional Modifier None Typical Low $91.20 Median $165.96 Typical High $223.87 | Professional | None | $91.20 | $165.96 | $223.87 |
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 $83.18 Median $181.97 Typical High $295.12 | Professional | None | $83.18 | $181.97 | $295.12 |
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 $72.44 Median $109.65 Typical High $229.09 | Professional | None | $72.44 | $109.65 | $229.09 |
Hometown Health Setting Professional Modifier None Typical Low $70.79 Median $177.83 Typical High $398.11 | Professional | None | $70.79 | $177.83 | $398.11 |
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 $1.32 Median $120.23 Typical High $2,238.72 | Professional | None | $1.32 | $120.23 | $2,238.72 |
Select Health Setting Facility Modifier None Typical Low $79.43 Median $223.87 Typical High $4,265.80 | Facility | None | $79.43 | $223.87 | $4,265.80 |
Select Health Setting Professional Modifier None Typical Low $67.61 Median $97.72 Typical High $223.87 | Professional | None | $67.61 | $97.72 | $223.87 |
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 $75.86 Median $147.91 Typical High $257.04 | Professional | None | $75.86 | $147.91 | $257.04 |
6 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 $45.71 Median $72.44 Typical High $112.20 | Professional | 52 · Reduced service | $45.71 | $72.44 | $112.20 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $18.20 Median $28.84 Typical High $44.67 | Professional | 53 · Discontinued | $18.20 | $28.84 | $44.67 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $67.61 Median $107.15 Typical High $165.96 | Professional | 54 · Surgery only | $67.61 | $107.15 | $165.96 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $13.49 Median $21.38 Typical High $33.11 | Professional | 55 · Aftercare only | $13.49 | $21.38 | $33.11 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $9.12 Median $14.45 Typical High $22.39 | Professional | 56 · Pre-op care only | $9.12 | $14.45 | $22.39 |
Ambetter Setting Professional Modifier 33 · Preventive service Typical Low $83.18 Median $83.18 Typical High $83.18 | Professional | 33 · Preventive service | $83.18 | $83.18 | $83.18 |
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· 39th 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.