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 $77.62 Median $1,698.24 Typical High $4,466.84 | Facility | None | $77.62 | $1,698.24 | $4,466.84 |
Aetna Setting Professional Modifier None Typical Low $77.62 Median $77.62 Typical High $104.71 | Professional | None | $77.62 | $77.62 | $104.71 |
Anthem BCBS Setting Facility Modifier None Typical Low $2,754.23 Median $4,466.84 Typical High $5,754.40 | Facility | None | $2,754.23 | $4,466.84 | $5,754.40 |
Anthem BCBS Setting Professional Modifier None Typical Low $72.44 Median $87.10 Typical High $158.49 | Professional | None | $72.44 | $87.10 | $158.49 |
Cigna Setting Facility Modifier None Typical Low $398.11 Median $1,318.26 Typical High $1,862.09 | Facility | None | $398.11 | $1,318.26 | $1,862.09 |
Cigna Setting Professional Modifier None Typical Low $61.66 Median $70.79 Typical High $181.97 | Professional | None | $61.66 | $70.79 | $181.97 |
Hometown Health Setting Professional Modifier None Typical Low $0.28 Median $72.44 Typical High $112.20 | Professional | None | $0.28 | $72.44 | $112.20 |
Hometown Health Setting Facility Modifier None Typical Low $1,318.26 Median $1,318.26 Typical High $1,318.26 | Facility | None | $1,318.26 | $1,318.26 | $1,318.26 |
Hometown Health Setting Professional Modifier None Typical Low $0.24 Median $0.24 Typical High $100.00 | Professional | None | $0.24 | $0.24 | $100.00 |
Select Health Setting Facility Modifier None Typical Low $66.07 Median $66.07 Typical High $4,265.80 | Facility | None | $66.07 | $66.07 | $4,265.80 |
Select Health Setting Professional Modifier None Typical Low $60.26 Median $60.26 Typical High $60.26 | Professional | None | $60.26 | $60.26 | $60.26 |
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 $30.20 Median $77.62 Typical High $131.83 | Professional | None | $30.20 | $77.62 | $131.83 |
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 $38.90 Median $38.90 Typical High $38.90 | Professional | 52 · Reduced service | $38.90 | $38.90 | $38.90 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $15.49 Median $15.49 Typical High $15.49 | Professional | 53 · Discontinued | $15.49 | $15.49 | $15.49 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $57.54 Median $57.54 Typical High $57.54 | Professional | 54 · Surgery only | $57.54 | $57.54 | $57.54 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $11.48 Median $11.48 Typical High $11.48 | Professional | 55 · Aftercare only | $11.48 | $11.48 | $11.48 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $7.76 Median $7.76 Typical High $7.76 | Professional | 56 · Pre-op care only | $7.76 | $7.76 | $7.76 |
Where Nevada sits
The same service costs 11.2 times more in Tennessee 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· 38th of 51
$100
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.