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 $162.18 Median $1,698.24 Typical High $4,466.84 | Facility | None | $162.18 | $1,698.24 | $4,466.84 |
Aetna Setting Professional Modifier None Typical Low $154.88 Median $162.18 Typical High $229.09 | Professional | None | $154.88 | $162.18 | $229.09 |
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 $173.78 Median $213.80 Typical High $389.05 | Professional | None | $173.78 | $213.80 | $389.05 |
Cigna Setting Facility Modifier None Typical Low $165.96 Median $190.55 Typical High $251.19 | Facility | None | $165.96 | $190.55 | $251.19 |
Cigna Setting Professional Modifier None Typical Low $154.88 Median $154.88 Typical High $302.00 | Professional | None | $154.88 | $154.88 | $302.00 |
Hometown Health Setting Professional Modifier None Typical Low $2.09 Median $186.21 Typical High $269.15 | Professional | None | $2.09 | $186.21 | $269.15 |
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 $1.82 Median $1.82 Typical High $234.42 | Professional | None | $1.82 | $1.82 | $234.42 |
Select Health Setting Facility Modifier None Typical Low $154.88 Median $154.88 Typical High $4,265.80 | Facility | None | $154.88 | $154.88 | $4,265.80 |
Select Health Setting Professional Modifier None Typical Low $138.04 Median $138.04 Typical High $138.04 | Professional | None | $138.04 | $138.04 | $138.04 |
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 $147.91 Median $190.55 Typical High $281.84 | Professional | None | $147.91 | $190.55 | $281.84 |
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 $77.62 Median $81.28 Typical High $81.28 | Professional | 52 · Reduced service | $77.62 | $81.28 | $81.28 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $30.90 Median $33.11 Typical High $33.11 | Professional | 53 · Discontinued | $30.90 | $33.11 | $33.11 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $114.82 Median $123.03 Typical High $123.03 | Professional | 54 · Surgery only | $114.82 | $123.03 | $123.03 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $22.91 Median $24.55 Typical High $24.55 | Professional | 55 · Aftercare only | $22.91 | $24.55 | $24.55 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $15.49 Median $16.22 Typical High $16.22 | Professional | 56 · Pre-op care only | $15.49 | $16.22 | $16.22 |
Where Nevada sits
The same service costs 3.2 times more in Alaska than in Texas. 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
$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.