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 $478.63 Median $1,698.24 Typical High $4,466.84 | Facility | None | $478.63 | $1,698.24 | $4,466.84 |
Aetna Setting Professional Modifier None Typical Low $446.68 Median $478.63 Typical High $660.69 | Professional | None | $446.68 | $478.63 | $660.69 |
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 $512.86 Median $616.60 Typical High $1,000.00 | Professional | None | $512.86 | $616.60 | $1,000.00 |
Cigna Setting Facility Modifier None Typical Low $173.78 Median $218.78 Typical High $549.54 | Facility | None | $173.78 | $218.78 | $549.54 |
Cigna Setting Professional Modifier None Typical Low $426.58 Median $446.68 Typical High $851.14 | Professional | None | $426.58 | $446.68 | $851.14 |
Hometown Health Setting Professional Modifier None Typical Low $3.16 Median $512.86 Typical High $758.58 | Professional | None | $3.16 | $512.86 | $758.58 |
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 $2.69 Median $2.69 Typical High $676.08 | Professional | None | $2.69 | $2.69 | $676.08 |
Select Health Setting Facility Modifier None Typical Low $446.68 Median $446.68 Typical High $4,265.80 | Facility | None | $446.68 | $446.68 | $4,265.80 |
Select Health Setting Professional Modifier None Typical Low $398.11 Median $398.11 Typical High $398.11 | Professional | None | $398.11 | $398.11 | $398.11 |
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 $389.05 Median $537.03 Typical High $831.76 | Professional | None | $389.05 | $537.03 | $831.76 |
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 $223.87 Median $239.88 Typical High $239.88 | Professional | 52 · Reduced service | $223.87 | $239.88 | $239.88 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $91.20 Median $95.50 Typical High $95.50 | Professional | 53 · Discontinued | $91.20 | $95.50 | $95.50 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $338.84 Median $363.08 Typical High $363.08 | Professional | 54 · Surgery only | $338.84 | $363.08 | $363.08 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $67.61 Median $72.44 Typical High $72.44 | Professional | 55 · Aftercare only | $67.61 | $72.44 | $72.44 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $44.67 Median $47.86 Typical High $47.86 | Professional | 56 · Pre-op care only | $44.67 | $47.86 | $47.86 |
Where Nevada sits
The same service costs 3.2 times more in Alaska than in Arkansas. 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
$537
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.