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 $147.91 Median $1,698.24 Typical High $4,365.16 | Facility | None | $147.91 | $1,698.24 | $4,365.16 |
Aetna Setting Professional Modifier None Typical Low $147.91 Median $181.97 Typical High $181.97 | Professional | None | $147.91 | $181.97 | $181.97 |
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 $138.04 Median $194.98 Typical High $309.03 | Professional | None | $138.04 | $194.98 | $309.03 |
Cigna Setting Facility Modifier None Typical Low $95.50 Median $117.49 Typical High $549.54 | Facility | None | $95.50 | $117.49 | $549.54 |
Cigna Setting Professional Modifier None Typical Low $120.23 Median $147.91 Typical High $263.03 | Professional | None | $120.23 | $147.91 | $263.03 |
Hometown Health Setting Professional Modifier None Typical Low $112.20 Median $165.96 Typical High $281.84 | Professional | None | $112.20 | $165.96 | $281.84 |
Hometown Health Setting Facility Modifier None Typical Low $95.50 Median $95.50 Typical High $95.50 | Facility | None | $95.50 | $95.50 | $95.50 |
Hometown Health Setting Professional Modifier None Typical Low $0.83 Median $141.25 Typical High $275.42 | Professional | None | $0.83 | $141.25 | $275.42 |
Select Health Setting Facility Modifier None Typical Low $125.89 Median $181.97 Typical High $4,265.80 | Facility | None | $125.89 | $181.97 | $4,265.80 |
Select Health Setting Professional Modifier None Typical Low $165.96 Median $165.96 Typical High $165.96 | Professional | None | $165.96 | $165.96 | $165.96 |
United Setting Facility Modifier None Typical Low $302.00 Median $512.86 Typical High $2,137.96 | Facility | None | $302.00 | $512.86 | $2,137.96 |
United Setting Professional Modifier None Typical Low $134.90 Median $181.97 Typical High $275.42 | Professional | None | $134.90 | $181.97 | $275.42 |
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 $74.13 Median $91.20 Typical High $91.20 | Professional | 52 · Reduced service | $74.13 | $91.20 | $91.20 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $29.51 Median $36.31 Typical High $36.31 | Professional | 53 · Discontinued | $29.51 | $36.31 | $36.31 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $109.65 Median $138.04 Typical High $138.04 | Professional | 54 · Surgery only | $109.65 | $138.04 | $138.04 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $21.88 Median $27.54 Typical High $27.54 | Professional | 55 · Aftercare only | $21.88 | $27.54 | $27.54 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $14.79 Median $18.20 Typical High $18.20 | Professional | 56 · Pre-op care only | $14.79 | $18.20 | $18.20 |
Where Nevada sits
The same service costs 3.4 times more in Alaska than in Pennsylvania. 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· 45th of 51
$182
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.