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 $151.36 Median $1,698.24 Typical High $4,466.84 | Facility | None | $151.36 | $1,698.24 | $4,466.84 |
Aetna Setting Professional Modifier None Typical Low $138.04 Median $138.04 Typical High $186.21 | Professional | None | $138.04 | $138.04 | $186.21 |
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 $144.54 Median $173.78 Typical High $309.03 | Professional | None | $144.54 | $173.78 | $309.03 |
Cigna Setting Facility Modifier None Typical Low $398.11 Median $575.44 Typical High $776.25 | Facility | None | $398.11 | $575.44 | $776.25 |
Cigna Setting Professional Modifier None Typical Low $123.03 Median $123.03 Typical High $239.88 | Professional | None | $123.03 | $123.03 | $239.88 |
Hometown Health Setting Professional Modifier None Typical Low $6.31 Median $22.39 Typical High $141.25 | Professional | None | $6.31 | $22.39 | $141.25 |
Hometown Health Setting Facility Modifier None Typical Low $524.81 Median $524.81 Typical High $524.81 | Facility | None | $524.81 | $524.81 | $524.81 |
Hometown Health Setting Professional Modifier None Typical Low $5.37 Median $5.37 Typical High $5.37 | Professional | None | $5.37 | $5.37 | $5.37 |
Select Health Setting Facility Modifier None Typical Low $144.54 Median $144.54 Typical High $4,265.80 | Facility | None | $144.54 | $144.54 | $4,265.80 |
Select Health Setting Professional Modifier None Typical Low $128.82 Median $128.82 Typical High $128.82 | Professional | None | $128.82 | $128.82 | $128.82 |
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 $123.03 Median $154.88 Typical High $588.84 | Professional | None | $123.03 | $154.88 | $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 $69.18 Median $69.18 Typical High $75.86 | Professional | 52 · Reduced service | $69.18 | $69.18 | $75.86 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $27.54 Median $27.54 Typical High $30.90 | Professional | 53 · Discontinued | $27.54 | $27.54 | $30.90 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $104.71 Median $104.71 Typical High $114.82 | Professional | 54 · Surgery only | $104.71 | $104.71 | $114.82 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $20.89 Median $20.89 Typical High $22.91 | Professional | 55 · Aftercare only | $20.89 | $20.89 | $22.91 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $13.80 Median $13.80 Typical High $15.14 | Professional | 56 · Pre-op care only | $13.80 | $13.80 | $15.14 |
Where Nevada sits
The same service costs 4.3 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· 41st of 51
$200
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.