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 $218.78 Median $1,698.24 Typical High $4,365.16 | Facility | None | $218.78 | $1,698.24 | $4,365.16 |
Aetna Setting Professional Modifier None Typical Low $199.53 Median $245.47 Typical High $269.15 | Professional | None | $199.53 | $245.47 | $269.15 |
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 $208.93 Median $288.40 Typical High $457.09 | Professional | None | $208.93 | $288.40 | $457.09 |
Cigna Setting Facility Modifier None Typical Low $173.78 Median $218.78 Typical High $512.86 | Facility | None | $173.78 | $218.78 | $512.86 |
Cigna Setting Professional Modifier None Typical Low $169.82 Median $204.17 Typical High $380.19 | Professional | None | $169.82 | $204.17 | $380.19 |
Hometown Health Setting Professional Modifier None Typical Low $173.78 Median $251.19 Typical High $398.11 | Professional | None | $173.78 | $251.19 | $398.11 |
Hometown Health Setting Facility Modifier None Typical Low $173.78 Median $173.78 Typical High $173.78 | Facility | None | $173.78 | $173.78 | $173.78 |
Hometown Health Setting Professional Modifier None Typical Low $7.24 Median $263.03 Typical High $380.19 | Professional | None | $7.24 | $263.03 | $380.19 |
Select Health Setting Facility Modifier None Typical Low $181.97 Median $251.19 Typical High $4,265.80 | Facility | None | $181.97 | $251.19 | $4,265.80 |
Select Health Setting Professional Modifier None Typical Low $229.09 Median $229.09 Typical High $229.09 | Professional | None | $229.09 | $229.09 | $229.09 |
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 $213.80 Median $257.04 Typical High $416.87 | Professional | None | $213.80 | $257.04 | $416.87 |
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 $100.00 Median $123.03 Typical High $134.90 | Professional | 52 · Reduced service | $100.00 | $123.03 | $134.90 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $39.81 Median $48.98 Typical High $53.70 | Professional | 53 · Discontinued | $39.81 | $48.98 | $53.70 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $147.91 Median $181.97 Typical High $199.53 | Professional | 54 · Surgery only | $147.91 | $181.97 | $199.53 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $30.20 Median $36.31 Typical High $40.74 | Professional | 55 · Aftercare only | $30.20 | $36.31 | $40.74 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $19.95 Median $24.55 Typical High $26.92 | Professional | 56 · Pre-op care only | $19.95 | $24.55 | $26.92 |
Where Nevada sits
The same service costs 3.7 times more in Alaska than in Maryland. 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· 44th of 51
$257
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.