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 $114.82 Median $186.21 Typical High $234.42 | Professional | None | $114.82 | $186.21 | $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 $107.15 Median $218.78 Typical High $323.59 | Professional | None | $107.15 | $218.78 | $323.59 |
Cigna Setting Facility Modifier None Typical Low $398.11 Median $707.95 Typical High $1,000.00 | Facility | None | $398.11 | $707.95 | $1,000.00 |
Cigna Setting Professional Modifier None Typical Low $97.72 Median $144.54 Typical High $257.04 | Professional | None | $97.72 | $144.54 | $257.04 |
Hometown Health Setting Professional Modifier None Typical Low $93.33 Median $204.17 Typical High $426.58 | Professional | None | $93.33 | $204.17 | $426.58 |
Hometown Health Setting Facility Modifier None Typical Low $691.83 Median $691.83 Typical High $691.83 | Facility | None | $691.83 | $691.83 | $691.83 |
Hometown Health Setting Professional Modifier None Typical Low $1.82 Median $151.36 Typical High $1,023.29 | Professional | None | $1.82 | $151.36 | $1,023.29 |
Select Health Setting Facility Modifier None Typical Low $100.00 Median $239.88 Typical High $4,265.80 | Facility | None | $100.00 | $239.88 | $4,265.80 |
Select Health Setting Professional Modifier None Typical Low $85.11 Median $125.89 Typical High $239.88 | Professional | None | $85.11 | $125.89 | $239.88 |
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 $104.71 Median $173.78 Typical High $281.84 | Professional | None | $104.71 | $173.78 | $281.84 |
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 $57.54 Median $83.18 Typical High $117.49 | Professional | 52 · Reduced service | $57.54 | $83.18 | $117.49 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $22.91 Median $33.88 Typical High $46.77 | Professional | 53 · Discontinued | $22.91 | $33.88 | $46.77 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $87.10 Median $125.89 Typical High $177.83 | Professional | 54 · Surgery only | $87.10 | $125.89 | $177.83 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $17.38 Median $25.12 Typical High $35.48 | Professional | 55 · Aftercare only | $17.38 | $25.12 | $35.48 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $11.48 Median $16.60 Typical High $23.44 | Professional | 56 · Pre-op care only | $11.48 | $16.60 | $23.44 |
Where Nevada sits
The same service costs 3.8 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· 38th of 51
$191
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.