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 $123.03 Median $1,698.24 Typical High $4,365.16 | Facility | None | $123.03 | $1,698.24 | $4,365.16 |
Aetna Setting Professional Modifier None Typical Low $123.03 Median $208.93 Typical High $234.42 | Professional | None | $123.03 | $208.93 | $234.42 |
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 $117.49 Median $199.53 Typical High $338.84 | Professional | None | $117.49 | $199.53 | $338.84 |
Cigna Setting Facility Modifier None Typical Low $398.11 Median $776.25 Typical High $1,122.02 | Facility | None | $398.11 | $776.25 | $1,122.02 |
Cigna Setting Professional Modifier None Typical Low $104.71 Median $165.96 Typical High $295.12 | Professional | None | $104.71 | $165.96 | $295.12 |
Hometown Health Setting Professional Modifier None Typical Low $112.20 Median $190.55 Typical High $933.25 | Professional | None | $112.20 | $190.55 | $933.25 |
Hometown Health Setting Facility Modifier None Typical Low $776.25 Median $776.25 Typical High $776.25 | Facility | None | $776.25 | $776.25 | $776.25 |
Hometown Health Setting Professional Modifier None Typical Low $0.42 Median $154.88 Typical High $1,174.90 | Professional | None | $0.42 | $154.88 | $1,174.90 |
Select Health Setting Facility Modifier None Typical Low $102.33 Median $204.17 Typical High $4,265.80 | Facility | None | $102.33 | $204.17 | $4,265.80 |
Select Health Setting Professional Modifier None Typical Low $181.97 Median $181.97 Typical High $181.97 | Professional | None | $181.97 | $181.97 | $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 $104.71 Median $194.98 Typical High $281.84 | Professional | None | $104.71 | $194.98 | $281.84 |
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 $61.66 Median $97.72 Typical High $104.71 | Professional | 52 · Reduced service | $61.66 | $97.72 | $104.71 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $25.12 Median $38.90 Typical High $42.66 | Professional | 53 · Discontinued | $25.12 | $38.90 | $42.66 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $93.33 Median $147.91 Typical High $158.49 | Professional | 54 · Surgery only | $93.33 | $147.91 | $158.49 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $18.62 Median $29.51 Typical High $31.62 | Professional | 55 · Aftercare only | $18.62 | $29.51 | $31.62 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $12.30 Median $19.50 Typical High $20.89 | Professional | 56 · Pre-op care only | $12.30 | $19.50 | $20.89 |
Where Nevada sits
The same service costs 4.0 times more in Alaska than in Kentucky. 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· 38th of 51
$209
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.