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 $112.20 Median $2,137.96 Typical High $10,715.19 | Facility | None | $112.20 | $2,137.96 | $10,715.19 |
Aetna Setting Professional Modifier None Typical Low $112.20 Median $134.90 Typical High $165.96 | Professional | None | $112.20 | $134.90 | $165.96 |
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 $128.82 Median $154.88 Typical High $288.40 | Professional | None | $128.82 | $154.88 | $288.40 |
Cigna Setting Facility Modifier None Typical Low $66.07 Median $75.86 Typical High $120.23 | Facility | None | $66.07 | $75.86 | $120.23 |
Cigna Setting Professional Modifier None Typical Low $114.82 Median $134.90 Typical High $239.88 | Professional | None | $114.82 | $134.90 | $239.88 |
Hometown Health Setting Professional Modifier None Typical Low $91.20 Median $151.36 Typical High $251.19 | Professional | None | $91.20 | $151.36 | $251.19 |
Hometown Health Setting Facility Modifier None Typical Low $69.18 Median $69.18 Typical High $69.18 | Facility | None | $69.18 | $69.18 | $69.18 |
Hometown Health Setting Professional Modifier None Typical Low $1.82 Median $104.71 Typical High $234.42 | Professional | None | $1.82 | $104.71 | $234.42 |
Select Health Setting Facility Modifier None Typical Low $114.82 Median $158.49 Typical High $4,265.80 | Facility | None | $114.82 | $158.49 | $4,265.80 |
Select Health Setting Professional Modifier None Typical Low $141.25 Median $141.25 Typical High $141.25 | Professional | None | $141.25 | $141.25 | $141.25 |
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 $128.82 Median $158.49 Typical High $245.47 | Professional | None | $128.82 | $158.49 | $245.47 |
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 $56.23 Median $67.61 Typical High $70.79 | Professional | 52 · Reduced service | $56.23 | $67.61 | $70.79 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $22.39 Median $26.92 Typical High $28.84 | Professional | 53 · Discontinued | $22.39 | $26.92 | $28.84 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $85.11 Median $100.00 Typical High $107.15 | Professional | 54 · Surgery only | $85.11 | $100.00 | $107.15 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $16.98 Median $19.95 Typical High $21.38 | Professional | 55 · Aftercare only | $16.98 | $19.95 | $21.38 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $11.22 Median $13.49 Typical High $14.13 | Professional | 56 · Pre-op care only | $11.22 | $13.49 | $14.13 |
Where Nevada sits
The same service costs 2.9 times more in Alaska than in Kentucky. 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· 48th of 51
$155
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.