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 $27.54 Median $1,698.24 Typical High $4,466.84 | Facility | None | $27.54 | $1,698.24 | $4,466.84 |
Aetna Setting Professional Modifier None Typical Low $22.39 Median $22.39 Typical High $46.77 | Professional | None | $22.39 | $22.39 | $46.77 |
Anthem BCBS Setting Facility Modifier None Typical Low $2,238.72 Median $3,548.13 Typical High $4,466.84 | Facility | None | $2,238.72 | $3,548.13 | $4,466.84 |
Anthem BCBS Setting Professional Modifier None Typical Low $26.30 Median $31.62 Typical High $52.48 | Professional | None | $26.30 | $31.62 | $52.48 |
Cigna Setting Facility Modifier None Typical Low $144.54 Median $177.83 Typical High $1,023.29 | Facility | None | $144.54 | $177.83 | $1,023.29 |
Cigna Setting Professional Modifier None Typical Low $18.62 Median $43.65 Typical High $95.50 | Professional | None | $18.62 | $43.65 | $95.50 |
Hometown Health Setting Facility Modifier None Typical Low $144.54 Median $144.54 Typical High $144.54 | Facility | None | $144.54 | $144.54 | $144.54 |
Select Health Setting Facility Modifier None Typical Low $40.74 Median $56.23 Typical High $4,265.80 | Facility | None | $40.74 | $56.23 | $4,265.80 |
Select Health Setting Professional Modifier None Typical Low $51.29 Median $51.29 Typical High $51.29 | Professional | None | $51.29 | $51.29 | $51.29 |
United Setting Facility Modifier None Typical Low $97.72 Median $245.47 Typical High $1,949.84 | Facility | None | $97.72 | $245.47 | $1,949.84 |
United Setting Professional Modifier None Typical Low $22.39 Median $28.84 Typical High $58.88 | Professional | None | $22.39 | $28.84 | $58.88 |
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 $11.22 Median $11.22 Typical High $13.80 | Professional | 52 · Reduced service | $11.22 | $11.22 | $13.80 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $4.47 Median $4.47 Typical High $5.50 | Professional | 53 · Discontinued | $4.47 | $4.47 | $5.50 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $16.98 Median $16.98 Typical High $20.89 | Professional | 54 · Surgery only | $16.98 | $16.98 | $20.89 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $3.39 Median $3.39 Typical High $4.17 | Professional | 55 · Aftercare only | $3.39 | $3.39 | $4.17 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $2.24 Median $2.24 Typical High $2.75 | Professional | 56 · Pre-op care only | $2.24 | $2.24 | $2.75 |
Where Nevada sits
The same service costs 9.1 times more in Tennessee than in Maine. 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· 43rd of 51
$48.98
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.