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 $208.93 Median $3,981.07 Typical High $10,715.19 | Facility | None | $208.93 | $3,981.07 | $10,715.19 |
Aetna Setting Professional Modifier None Typical Low $208.93 Median $213.80 Typical High $213.80 | Professional | None | $208.93 | $213.80 | $213.80 |
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 $204.17 Median $234.42 Typical High $371.54 | Professional | None | $204.17 | $234.42 | $371.54 |
Cigna Setting Facility Modifier None Typical Low $562.34 Median $758.58 Typical High $2,137.96 | Facility | None | $562.34 | $758.58 | $2,137.96 |
Cigna Setting Professional Modifier None Typical Low $162.18 Median $177.83 Typical High $371.54 | Professional | None | $162.18 | $177.83 | $371.54 |
Hometown Health Setting Professional Modifier None Typical Low $6.03 Median $162.18 Typical High $288.40 | Professional | None | $6.03 | $162.18 | $288.40 |
Hometown Health Setting Professional Modifier None Typical Low $4.47 Median $4.47 Typical High $269.15 | Professional | None | $4.47 | $4.47 | $269.15 |
Select Health Setting Facility Modifier None Typical Low $181.97 Median $181.97 Typical High $4,265.80 | Facility | None | $181.97 | $181.97 | $4,265.80 |
Select Health Setting Professional Modifier None Typical Low $144.54 Median $181.97 Typical High $478.63 | Professional | None | $144.54 | $181.97 | $478.63 |
United Setting Facility Modifier None Typical Low $302.00 Median $794.33 Typical High $2,951.21 | Facility | None | $302.00 | $794.33 | $2,951.21 |
United Setting Professional Modifier None Typical Low $177.83 Median $223.87 Typical High $316.23 | Professional | None | $177.83 | $223.87 | $316.23 |
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 $104.71 Median $107.15 Typical High $107.15 | Professional | 52 · Reduced service | $104.71 | $107.15 | $107.15 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $42.66 Median $42.66 Typical High $42.66 | Professional | 53 · Discontinued | $42.66 | $42.66 | $42.66 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $158.49 Median $162.18 Typical High $162.18 | Professional | 54 · Surgery only | $158.49 | $162.18 | $162.18 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $31.62 Median $32.36 Typical High $32.36 | Professional | 55 · Aftercare only | $31.62 | $32.36 | $32.36 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $20.89 Median $21.38 Typical High $21.38 | Professional | 56 · Pre-op care only | $20.89 | $21.38 | $21.38 |
Where Nevada sits
The same service costs 5.1 times more in Alaska than in Utah. 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· 40th of 51
$229
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.