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 $173.78 Median $3,981.07 Typical High $10,715.19 | Facility | None | $173.78 | $3,981.07 | $10,715.19 |
Aetna Setting Professional Modifier None Typical Low $173.78 Median $186.21 Typical High $199.53 | Professional | None | $173.78 | $186.21 | $199.53 |
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 $194.98 Median $239.88 Typical High $436.52 | Professional | None | $194.98 | $239.88 | $436.52 |
Cigna Setting Facility Modifier None Typical Low $165.96 Median $190.55 Typical High $302.00 | Facility | None | $165.96 | $190.55 | $302.00 |
Cigna Setting Professional Modifier None Typical Low $173.78 Median $186.21 Typical High $338.84 | Professional | None | $173.78 | $186.21 | $338.84 |
Hometown Health Setting Professional Modifier None Typical Low $2.82 Median $208.93 Typical High $302.00 | Professional | None | $2.82 | $208.93 | $302.00 |
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 $2.40 Median $2.40 Typical High $263.03 | Professional | None | $2.40 | $2.40 | $263.03 |
Select Health Setting Facility Modifier None Typical Low $173.78 Median $173.78 Typical High $4,265.80 | Facility | None | $173.78 | $173.78 | $4,265.80 |
Select Health Setting Professional Modifier None Typical Low $154.88 Median $154.88 Typical High $154.88 | Professional | None | $154.88 | $154.88 | $154.88 |
United Setting Facility Modifier None Typical Low $97.72 Median $245.47 Typical High $1,949.84 | Facility | None | $97.72 | $245.47 | $1,949.84 |
United Setting Professional Modifier None Typical Low $104.71 Median $213.80 Typical High $338.84 | Professional | None | $104.71 | $213.80 | $338.84 |
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 $87.10 Median $93.33 Typical High $93.33 | Professional | 52 · Reduced service | $87.10 | $93.33 | $93.33 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $34.67 Median $37.15 Typical High $37.15 | Professional | 53 · Discontinued | $34.67 | $37.15 | $37.15 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $131.83 Median $138.04 Typical High $138.04 | Professional | 54 · Surgery only | $131.83 | $138.04 | $138.04 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $26.30 Median $27.54 Typical High $27.54 | Professional | 55 · Aftercare only | $26.30 | $27.54 | $27.54 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $17.38 Median $18.62 Typical High $18.62 | Professional | 56 · Pre-op care only | $17.38 | $18.62 | $18.62 |
Where Nevada sits
The same service costs 3.2 times more in Alaska than in Utah. 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
$224
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.