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 $114.82 Median $1,698.24 Typical High $4,365.16 | Facility | None | $114.82 | $1,698.24 | $4,365.16 |
Aetna Setting Professional Modifier None Typical Low $112.20 Median $213.80 Typical High $257.04 | Professional | None | $112.20 | $213.80 | $257.04 |
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 $138.04 Typical High $245.47 | Professional | None | $112.20 | $138.04 | $245.47 |
Cigna Setting Professional Modifier None Typical Low $100.00 Median $194.98 Typical High $398.11 | Professional | None | $100.00 | $194.98 | $398.11 |
Hometown Health Setting Professional Modifier None Typical Low $102.33 Median $190.55 Typical High $371.54 | Professional | None | $102.33 | $190.55 | $371.54 |
Hometown Health Setting Professional Modifier None Typical Low $1.82 Median $147.91 Typical High $363.08 | Professional | None | $1.82 | $147.91 | $363.08 |
Select Health Setting Facility Modifier None Typical Low $100.00 Median $239.88 Typical High $4,265.80 | Facility | None | $100.00 | $239.88 | $4,265.80 |
Select Health Setting Professional Modifier None Typical Low $75.86 Median $75.86 Typical High $100.00 | Professional | None | $75.86 | $75.86 | $100.00 |
United Setting Facility Modifier None Typical Low $691.83 Median $2,137.96 Typical High $4,786.30 | Facility | None | $691.83 | $2,137.96 | $4,786.30 |
United Setting Professional Modifier None Typical Low $123.03 Median $239.88 Typical High $380.19 | Professional | None | $123.03 | $239.88 | $380.19 |
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 $56.23 Median $107.15 Typical High $128.82 | Professional | 52 · Reduced service | $56.23 | $107.15 | $128.82 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $22.91 Median $43.65 Typical High $51.29 | Professional | 53 · Discontinued | $22.91 | $43.65 | $51.29 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $85.11 Median $162.18 Typical High $194.98 | Professional | 54 · Surgery only | $85.11 | $162.18 | $194.98 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $16.98 Median $32.36 Typical High $38.90 | Professional | 55 · Aftercare only | $16.98 | $32.36 | $38.90 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $11.22 Median $21.38 Typical High $25.70 | Professional | 56 · Pre-op care only | $11.22 | $21.38 | $25.70 |
Where Nevada sits
The same service costs 3.4 times more in Alaska than in Virginia. 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· 43rd of 51
$209
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.