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 $12.59 Median $16.22 Typical High $79.43 | Facility | None | $12.59 | $16.22 | $79.43 |
Aetna Setting Professional Modifier None Typical Low $11.48 Median $14.13 Typical High $17.78 | Professional | None | $11.48 | $14.13 | $17.78 |
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 $12.02 Median $16.60 Typical High $25.12 | Professional | None | $12.02 | $16.60 | $25.12 |
Cigna Setting Facility Modifier None Typical Low $6.31 Median $7.94 Typical High $549.54 | Facility | None | $6.31 | $7.94 | $549.54 |
Cigna Setting Professional Modifier None Typical Low $10.47 Median $13.80 Typical High $26.30 | Professional | None | $10.47 | $13.80 | $26.30 |
Hometown Health Setting Professional Modifier None Typical Low $8.13 Median $14.13 Typical High $22.91 | Professional | None | $8.13 | $14.13 | $22.91 |
Hometown Health Setting Facility Modifier None Typical Low $6.31 Median $6.31 Typical High $6.31 | Facility | None | $6.31 | $6.31 | $6.31 |
Hometown Health Setting Professional Modifier None Typical Low $0.24 Median $9.55 Typical High $21.88 | Professional | None | $0.24 | $9.55 | $21.88 |
Select Health Setting Facility Modifier None Typical Low $10.23 Median $14.45 Typical High $4,265.80 | Facility | None | $10.23 | $14.45 | $4,265.80 |
Select Health Setting Professional Modifier None Typical Low $12.88 Median $12.88 Typical High $12.88 | Professional | None | $12.88 | $12.88 | $12.88 |
United Setting Facility Modifier None Typical Low $97.72 Median $234.42 Typical High $1,949.84 | Facility | None | $97.72 | $234.42 | $1,949.84 |
United Setting Professional Modifier None Typical Low $12.59 Median $16.98 Typical High $29.51 | Professional | None | $12.59 | $16.98 | $29.51 |
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 $5.75 Median $7.08 Typical High $7.76 | Professional | 52 · Reduced service | $5.75 | $7.08 | $7.76 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $2.29 Median $2.82 Typical High $3.09 | Professional | 53 · Discontinued | $2.29 | $2.82 | $3.09 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $8.71 Median $10.47 Typical High $11.48 | Professional | 54 · Surgery only | $8.71 | $10.47 | $11.48 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $1.74 Median $2.09 Typical High $2.29 | Professional | 55 · Aftercare only | $1.74 | $2.09 | $2.29 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $1.15 Median $1.41 Typical High $1.55 | Professional | 56 · Pre-op care only | $1.15 | $1.41 | $1.55 |
Where Nevada sits
The same service costs 3.5 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· 47th of 51
$15.85
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.