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 $25.12 Median $2,238.72 Typical High $5,011.87 | Facility | None | $25.12 | $2,238.72 | $5,011.87 |
Aetna Setting Professional Modifier None Typical Low $24.55 Median $30.90 Typical High $31.62 | Professional | None | $24.55 | $30.90 | $31.62 |
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 $24.55 Median $28.18 Typical High $45.71 | Professional | None | $24.55 | $28.18 | $45.71 |
Cigna Setting Facility Modifier None Typical Low $16.98 Median $20.89 Typical High $676.08 | Facility | None | $16.98 | $20.89 | $676.08 |
Cigna Setting Professional Modifier None Typical Low $20.42 Median $33.88 Typical High $53.70 | Professional | None | $20.42 | $33.88 | $53.70 |
Hometown Health Setting Professional Modifier None Typical Low $16.98 Median $28.84 Typical High $47.86 | Professional | None | $16.98 | $28.84 | $47.86 |
Hometown Health Setting Facility Modifier None Typical Low $16.98 Median $16.98 Typical High $16.98 | Facility | None | $16.98 | $16.98 | $16.98 |
Hometown Health Setting Professional Modifier None Typical Low $0.48 Median $25.12 Typical High $50.12 | Professional | None | $0.48 | $25.12 | $50.12 |
Select Health Setting Facility Modifier None Typical Low $20.89 Median $33.11 Typical High $4,265.80 | Facility | None | $20.89 | $33.11 | $4,265.80 |
Select Health Setting Professional Modifier None Typical Low $16.98 Median $27.54 Typical High $33.88 | Professional | None | $16.98 | $27.54 | $33.88 |
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 $22.39 Median $34.67 Typical High $57.54 | Professional | None | $22.39 | $34.67 | $57.54 |
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 $12.30 Median $14.13 Typical High $15.85 | Professional | 52 · Reduced service | $12.30 | $14.13 | $15.85 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $4.90 Median $5.62 Typical High $6.31 | Professional | 53 · Discontinued | $4.90 | $5.62 | $6.31 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $18.62 Median $21.38 Typical High $23.99 | Professional | 54 · Surgery only | $18.62 | $21.38 | $23.99 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $3.72 Median $4.27 Typical High $4.79 | Professional | 55 · Aftercare only | $3.72 | $4.27 | $4.79 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $2.45 Median $2.82 Typical High $3.16 | Professional | 56 · Pre-op care only | $2.45 | $2.82 | $3.16 |
Where Nevada sits
The same service costs 3.5 times more in Alaska than in Maryland. 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· 45th of 51
$31.62
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.