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 $120.23 Median $3,981.07 Typical High $8,128.31 | Facility | None | $120.23 | $3,981.07 | $8,128.31 |
Aetna Setting Professional Modifier None Typical Low $114.82 Median $120.23 Typical High $199.53 | Professional | None | $114.82 | $120.23 | $199.53 |
Anthem BCBS Setting Facility Modifier None Typical Low $2,570.40 Median $3,801.89 Typical High $5,128.61 | Facility | None | $2,570.40 | $3,801.89 | $5,128.61 |
Anthem BCBS Setting Professional Modifier None Typical Low $128.82 Median $158.49 Typical High $288.40 | Professional | None | $128.82 | $158.49 | $288.40 |
Cigna Setting Facility Modifier None Typical Low $831.76 Median $1,905.46 Typical High $2,630.27 | Facility | None | $831.76 | $1,905.46 | $2,630.27 |
Cigna Setting Professional Modifier None Typical Low $114.82 Median $134.90 Typical High $223.87 | Professional | None | $114.82 | $134.90 | $223.87 |
Hometown Health Setting Professional Modifier None Typical Low $2.09 Median $138.04 Typical High $204.17 | Professional | None | $2.09 | $138.04 | $204.17 |
Hometown Health Setting Facility Modifier None Typical Low $1,819.70 Median $1,819.70 Typical High $1,819.70 | Facility | None | $1,819.70 | $1,819.70 | $1,819.70 |
Hometown Health Setting Professional Modifier None Typical Low $1.82 Median $1.82 Typical High $173.78 | Professional | None | $1.82 | $1.82 | $173.78 |
Select Health Setting Facility Modifier None Typical Low $117.49 Median $117.49 Typical High $4,265.80 | Facility | None | $117.49 | $117.49 | $4,265.80 |
Select Health Setting Professional Modifier None Typical Low $104.71 Median $104.71 Typical High $104.71 | Professional | None | $104.71 | $104.71 | $104.71 |
United Setting Facility Modifier None Typical Low $1,174.90 Median $1,698.24 Typical High $4,073.80 | Facility | None | $1,174.90 | $1,698.24 | $4,073.80 |
United Setting Professional Modifier None Typical Low $117.49 Median $158.49 Typical High $251.19 | Professional | None | $117.49 | $158.49 | $251.19 |
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 $57.54 Median $60.26 Typical High $60.26 | Professional | 52 · Reduced service | $57.54 | $60.26 | $60.26 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $22.91 Median $23.99 Typical High $23.99 | Professional | 53 · Discontinued | $22.91 | $23.99 | $23.99 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $85.11 Median $91.20 Typical High $91.20 | Professional | 54 · Surgery only | $85.11 | $91.20 | $91.20 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $16.98 Median $18.20 Typical High $18.20 | Professional | 55 · Aftercare only | $16.98 | $18.20 | $18.20 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $11.48 Median $12.02 Typical High $12.02 | Professional | 56 · Pre-op care only | $11.48 | $12.02 | $12.02 |
Where Nevada sits
The same service costs 10.7 times more in Oklahoma than in New York. 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· 39th of 51
$178
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.