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 $707.95 Median $1,698.24 Typical High $4,466.84 | Facility | None | $707.95 | $1,698.24 | $4,466.84 |
Aetna Setting Professional Modifier None Typical Low $575.44 Median $575.44 Typical High $724.44 | Professional | None | $575.44 | $575.44 | $724.44 |
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 $549.54 Median $660.69 Typical High $1,202.26 | Professional | None | $549.54 | $660.69 | $1,202.26 |
Cigna Setting Facility Modifier None Typical Low $676.08 Median $5,248.07 Typical High $7,585.78 | Facility | None | $676.08 | $5,248.07 | $7,585.78 |
Cigna Setting Professional Modifier None Typical Low $467.74 Median $512.86 Typical High $912.01 | Professional | None | $467.74 | $512.86 | $912.01 |
Hometown Health Setting Professional Modifier None Typical Low $9.55 Median $562.34 Typical High $851.14 | Professional | None | $9.55 | $562.34 | $851.14 |
Hometown Health Setting Facility Modifier None Typical Low $5,248.07 Median $5,248.07 Typical High $5,248.07 | Facility | None | $5,248.07 | $5,248.07 | $5,248.07 |
Hometown Health Setting Professional Modifier None Typical Low $8.13 Median $8.13 Typical High $724.44 | Professional | None | $8.13 | $8.13 | $724.44 |
Select Health Setting Facility Modifier None Typical Low $478.63 Median $478.63 Typical High $4,265.80 | Facility | None | $478.63 | $478.63 | $4,265.80 |
Select Health Setting Professional Modifier None Typical Low $436.52 Median $436.52 Typical High $436.52 | Professional | None | $436.52 | $436.52 | $436.52 |
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 $120.23 Median $602.56 Typical High $933.25 | Professional | None | $120.23 | $602.56 | $933.25 |
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 $288.40 Median $288.40 Typical High $354.81 | Professional | 52 · Reduced service | $288.40 | $288.40 | $354.81 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $114.82 Median $114.82 Typical High $141.25 | Professional | 53 · Discontinued | $114.82 | $114.82 | $141.25 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $426.58 Median $426.58 Typical High $524.81 | Professional | 54 · Surgery only | $426.58 | $426.58 | $524.81 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $85.11 Median $85.11 Typical High $104.71 | Professional | 55 · Aftercare only | $85.11 | $85.11 | $104.71 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $57.54 Median $57.54 Typical High $70.79 | Professional | 56 · Pre-op care only | $57.54 | $57.54 | $70.79 |
Where Nevada sits
The same service costs 3.9 times more in Alaska than in New York. 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· 40th of 51
$692
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.