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 $66.07 Median $1,698.24 Typical High $4,365.16 | Facility | None | $66.07 | $1,698.24 | $4,365.16 |
Aetna Setting Professional Modifier None Typical Low $66.07 Median $112.20 Typical High $177.83 | Professional | None | $66.07 | $112.20 | $177.83 |
Anthem BCBS Setting Facility Modifier None Typical Low $2,570.40 Median $3,801.89 Typical High $5,128.61 | Facility | None | $2,570.40 | $3,801.89 | $5,128.61 |
Anthem BCBS Setting Professional Modifier None Typical Low $61.66 Median $144.54 Typical High $239.88 | Professional | None | $61.66 | $144.54 | $239.88 |
Cigna Setting Facility Modifier None Typical Low $151.36 Median $190.55 Typical High $912.01 | Facility | None | $151.36 | $190.55 | $912.01 |
Cigna Setting Professional Modifier None Typical Low $53.70 Median $107.15 Typical High $199.53 | Professional | None | $53.70 | $107.15 | $199.53 |
Hometown Health Setting Professional Modifier None Typical Low $51.29 Median $104.71 Typical High $218.78 | Professional | None | $51.29 | $104.71 | $218.78 |
Hometown Health Setting Facility Modifier None Typical Low $151.36 Median $151.36 Typical High $151.36 | Facility | None | $151.36 | $151.36 | $151.36 |
Hometown Health Setting Professional Modifier None Typical Low $1.70 Median $91.20 Typical High $275.42 | Professional | None | $1.70 | $91.20 | $275.42 |
Select Health Setting Facility Modifier None Typical Low $60.26 Median $181.97 Typical High $4,265.80 | Facility | None | $60.26 | $181.97 | $4,265.80 |
Select Health Setting Professional Modifier None Typical Low $51.29 Median $74.13 Typical High $181.97 | Professional | None | $51.29 | $74.13 | $181.97 |
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 $64.57 Median $134.90 Typical High $208.93 | Professional | None | $64.57 | $134.90 | $208.93 |
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 $33.11 Median $53.70 Typical High $89.13 | Professional | 52 · Reduced service | $33.11 | $53.70 | $89.13 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $13.18 Median $21.38 Typical High $35.48 | Professional | 53 · Discontinued | $13.18 | $21.38 | $35.48 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $50.12 Median $81.28 Typical High $134.90 | Professional | 54 · Surgery only | $50.12 | $81.28 | $134.90 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $10.00 Median $16.22 Typical High $26.92 | Professional | 55 · Aftercare only | $10.00 | $16.22 | $26.92 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $6.61 Median $10.72 Typical High $17.78 | Professional | 56 · Pre-op care only | $6.61 | $10.72 | $17.78 |
Where Nevada sits
The same service costs 3.7 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· 44th of 51
$123
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.