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 $288.40 Median $2,238.72 Typical High $5,011.87 | Facility | None | $288.40 | $2,238.72 | $5,011.87 |
Aetna Setting Professional Modifier None Typical Low $263.03 Median $346.74 Typical High $398.11 | Professional | None | $263.03 | $346.74 | $398.11 |
Anthem BCBS Setting Facility Modifier None Typical Low $5,495.41 Median $11,481.54 Typical High $18,197.01 | Facility | None | $5,495.41 | $11,481.54 | $18,197.01 |
Anthem BCBS Setting Professional Modifier None Typical Low $275.42 Median $426.58 Typical High $707.95 | Professional | None | $275.42 | $426.58 | $707.95 |
Cigna Setting Facility Modifier None Typical Low $537.03 Median $2,398.83 Typical High $3,467.37 | Facility | None | $537.03 | $2,398.83 | $3,467.37 |
Cigna Setting Professional Modifier None Typical Low $229.09 Median $354.81 Typical High $616.60 | Professional | None | $229.09 | $354.81 | $616.60 |
Hometown Health Setting Professional Modifier None Typical Low $263.03 Median $416.87 Typical High $2,754.23 | Professional | None | $263.03 | $416.87 | $2,754.23 |
Hometown Health Setting Facility Modifier None Typical Low $2,398.83 Median $2,398.83 Typical High $2,398.83 | Facility | None | $2,398.83 | $2,398.83 | $2,398.83 |
Hometown Health Setting Professional Modifier None Typical Low $4.17 Median $354.81 Typical High $3,630.78 | Professional | None | $4.17 | $354.81 | $3,630.78 |
Select Health Setting Facility Modifier None Typical Low $234.42 Median $398.11 Typical High $4,265.80 | Facility | None | $234.42 | $398.11 | $4,265.80 |
Select Health Setting Professional Modifier None Typical Low $354.81 Median $354.81 Typical High $354.81 | Professional | None | $354.81 | $354.81 | $354.81 |
United Setting Facility Modifier None Typical Low $302.00 Median $512.86 Typical High $4,786.30 | Facility | None | $302.00 | $512.86 | $4,786.30 |
United Setting Professional Modifier None Typical Low $281.84 Median $398.11 Typical High $588.84 | Professional | None | $281.84 | $398.11 | $588.84 |
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 $131.83 Median $177.83 Typical High $199.53 | Professional | 52 · Reduced service | $131.83 | $177.83 | $199.53 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $52.48 Median $70.79 Typical High $79.43 | Professional | 53 · Discontinued | $52.48 | $70.79 | $79.43 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $194.98 Median $263.03 Typical High $302.00 | Professional | 54 · Surgery only | $194.98 | $263.03 | $302.00 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $38.90 Median $53.70 Typical High $60.26 | Professional | 55 · Aftercare only | $38.90 | $53.70 | $60.26 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $26.30 Median $35.48 Typical High $39.81 | Professional | 56 · Pre-op care only | $26.30 | $35.48 | $39.81 |
Where Nevada sits
The same service costs 3.9 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· 42nd of 51
$398
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.