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 $426.58 Median $2,570.40 Typical High $6,165.95 | Facility | None | $426.58 | $2,570.40 | $6,165.95 |
Aetna Setting Professional Modifier None Typical Low $346.74 Median $346.74 Typical High $446.68 | Professional | None | $346.74 | $346.74 | $446.68 |
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 $331.13 Median $398.11 Typical High $741.31 | Professional | None | $331.13 | $398.11 | $741.31 |
Cigna Setting Facility Modifier None Typical Low $562.34 Median $1,905.46 Typical High $2,630.27 | Facility | None | $562.34 | $1,905.46 | $2,630.27 |
Cigna Setting Professional Modifier None Typical Low $295.12 Median $316.23 Typical High $562.34 | Professional | None | $295.12 | $316.23 | $562.34 |
Hometown Health Setting Professional Modifier None Typical Low $6.76 Median $346.74 Typical High $524.81 | Professional | None | $6.76 | $346.74 | $524.81 |
Hometown Health Setting Facility Modifier None Typical Low $1,819.70 Median $1,819.70 Typical High $1,819.70 | Facility | None | $1,819.70 | $1,819.70 | $1,819.70 |
Hometown Health Setting Professional Modifier None Typical Low $5.75 Median $5.75 Typical High $446.68 | Professional | None | $5.75 | $5.75 | $446.68 |
Select Health Setting Facility Modifier None Typical Low $295.12 Median $295.12 Typical High $4,265.80 | Facility | None | $295.12 | $295.12 | $4,265.80 |
Select Health Setting Professional Modifier None Typical Low $269.15 Median $269.15 Typical High $269.15 | Professional | None | $269.15 | $269.15 | $269.15 |
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 $295.12 Median $398.11 Typical High $575.44 | Professional | None | $295.12 | $398.11 | $575.44 |
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 $173.78 Median $173.78 Typical High $213.80 | Professional | 52 · Reduced service | $173.78 | $173.78 | $213.80 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $69.18 Median $69.18 Typical High $85.11 | Professional | 53 · Discontinued | $69.18 | $69.18 | $85.11 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $263.03 Median $263.03 Typical High $323.59 | Professional | 54 · Surgery only | $263.03 | $263.03 | $323.59 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $52.48 Median $52.48 Typical High $64.57 | Professional | 55 · Aftercare only | $52.48 | $52.48 | $64.57 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $34.67 Median $34.67 Typical High $42.66 | Professional | 56 · Pre-op care only | $34.67 | $34.67 | $42.66 |
Where Nevada sits
The same service costs 4.7 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
$457
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.