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 $117.49 Median $1,698.24 Typical High $4,466.84 | Facility | None | $117.49 | $1,698.24 | $4,466.84 |
Aetna Setting Professional Modifier None Typical Low $114.82 Median $117.49 Typical High $144.54 | Professional | None | $114.82 | $117.49 | $144.54 |
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 $112.20 Median $134.90 Typical High $245.47 | Professional | None | $112.20 | $134.90 | $245.47 |
Cigna Setting Facility Modifier None Typical Low $371.54 Median $446.68 Typical High $691.83 | Facility | None | $371.54 | $446.68 | $691.83 |
Cigna Setting Professional Modifier None Typical Low $91.20 Median $100.00 Typical High $186.21 | Professional | None | $91.20 | $100.00 | $186.21 |
Hometown Health Setting Professional Modifier None Typical Low $1.41 Median $123.03 Typical High $181.97 | Professional | None | $1.41 | $123.03 | $181.97 |
Hometown Health Setting Facility Modifier None Typical Low $407.38 Median $407.38 Typical High $407.38 | Facility | None | $407.38 | $407.38 | $407.38 |
Hometown Health Setting Professional Modifier None Typical Low $1.20 Median $1.20 Typical High $162.18 | Professional | None | $1.20 | $1.20 | $162.18 |
Select Health Setting Facility Modifier None Typical Low $107.15 Median $107.15 Typical High $4,265.80 | Facility | None | $107.15 | $107.15 | $4,265.80 |
Select Health Setting Professional Modifier None Typical Low $97.72 Median $97.72 Typical High $97.72 | Professional | None | $97.72 | $97.72 | $97.72 |
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 $100.00 Median $120.23 Typical High $186.21 | Professional | None | $100.00 | $120.23 | $186.21 |
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 $58.88 Typical High $58.88 | Professional | 52 · Reduced service | $57.54 | $58.88 | $58.88 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $22.91 Median $23.44 Typical High $23.44 | Professional | 53 · Discontinued | $22.91 | $23.44 | $23.44 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $85.11 Median $87.10 Typical High $87.10 | Professional | 54 · Surgery only | $85.11 | $87.10 | $87.10 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $17.38 Median $17.38 Typical High $17.38 | Professional | 55 · Aftercare only | $17.38 | $17.38 | $17.38 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $11.48 Median $11.75 Typical High $11.75 | Professional | 56 · Pre-op care only | $11.48 | $11.75 | $11.75 |
Where Nevada sits
The same service costs 4.4 times more in Alaska 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· 44th of 51
$145
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.