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 $446.68 Median $1,698.24 Typical High $4,466.84 | Facility | None | $446.68 | $1,698.24 | $4,466.84 |
Aetna Setting Professional Modifier None Typical Low $363.08 Median $363.08 Typical High $457.09 | Professional | None | $363.08 | $363.08 | $457.09 |
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 $346.74 Median $416.87 Typical High $758.58 | Professional | None | $346.74 | $416.87 | $758.58 |
Cigna Setting Facility Modifier None Typical Low $398.11 Median $2,818.38 Typical High $4,073.80 | Facility | None | $398.11 | $2,818.38 | $4,073.80 |
Cigna Setting Professional Modifier None Typical Low $295.12 Median $302.00 Typical High $575.44 | Professional | None | $295.12 | $302.00 | $575.44 |
Hometown Health Setting Professional Modifier None Typical Low $1.82 Median $338.84 Typical High $524.81 | Professional | None | $1.82 | $338.84 | $524.81 |
Hometown Health Setting Facility Modifier None Typical Low $2,818.38 Median $2,818.38 Typical High $2,818.38 | Facility | None | $2,818.38 | $2,818.38 | $2,818.38 |
Hometown Health Setting Professional Modifier None Typical Low $1.55 Median $1.55 Typical High $457.09 | Professional | None | $1.55 | $1.55 | $457.09 |
Select Health Setting Facility Modifier None Typical Low $309.03 Median $309.03 Typical High $4,265.80 | Facility | None | $309.03 | $309.03 | $4,265.80 |
Select Health Setting Professional Modifier None Typical Low $275.42 Median $275.42 Typical High $275.42 | Professional | None | $275.42 | $275.42 | $275.42 |
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 $120.23 Median $380.19 Typical High $588.84 | Professional | None | $120.23 | $380.19 | $588.84 |
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 $181.97 Median $181.97 Typical High $223.87 | Professional | 52 · Reduced service | $181.97 | $181.97 | $223.87 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $72.44 Median $72.44 Typical High $89.13 | Professional | 53 · Discontinued | $72.44 | $72.44 | $89.13 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $269.15 Median $269.15 Typical High $331.13 | Professional | 54 · Surgery only | $269.15 | $269.15 | $331.13 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $53.70 Median $53.70 Typical High $67.61 | Professional | 55 · Aftercare only | $53.70 | $53.70 | $67.61 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $36.31 Median $36.31 Typical High $44.67 | Professional | 56 · Pre-op care only | $36.31 | $36.31 | $44.67 |
Where Nevada sits
The same service costs 7.8 times more in Oklahoma 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· 42nd of 51
$447
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.