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 $112.20 Median $1,698.24 Typical High $4,365.16 | Facility | None | $112.20 | $1,698.24 | $4,365.16 |
Aetna Setting Professional Modifier None Typical Low $51.29 Median $100.00 Typical High $114.82 | Professional | None | $51.29 | $100.00 | $114.82 |
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 $50.12 Median $57.54 Typical High $93.33 | Professional | None | $50.12 | $57.54 | $93.33 |
Cigna Setting Facility Modifier None Typical Low $95.50 Median $117.49 Typical High $549.54 | Facility | None | $95.50 | $117.49 | $549.54 |
Cigna Setting Professional Modifier None Typical Low $56.23 Median $100.00 Typical High $162.18 | Professional | None | $56.23 | $100.00 | $162.18 |
Hometown Health Setting Professional Modifier None Typical Low $47.86 Median $85.11 Typical High $162.18 | Professional | None | $47.86 | $85.11 | $162.18 |
Hometown Health Setting Facility Modifier None Typical Low $95.50 Median $95.50 Typical High $95.50 | Facility | None | $95.50 | $95.50 | $95.50 |
Hometown Health Setting Professional Modifier None Typical Low $1.51 Median $69.18 Typical High $181.97 | Professional | None | $1.51 | $69.18 | $181.97 |
Select Health Setting Facility Modifier None Typical Low $46.77 Median $120.23 Typical High $4,265.80 | Facility | None | $46.77 | $120.23 | $4,265.80 |
Select Health Setting Professional Modifier None Typical Low $37.15 Median $70.79 Typical High $114.82 | Professional | None | $37.15 | $70.79 | $114.82 |
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 $48.98 Median $93.33 Typical High $169.82 | Professional | None | $48.98 | $93.33 | $169.82 |
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 $25.70 Median $47.86 Typical High $57.54 | Professional | 52 · Reduced service | $25.70 | $47.86 | $57.54 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $10.23 Median $19.05 Typical High $22.91 | Professional | 53 · Discontinued | $10.23 | $19.05 | $22.91 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $38.90 Median $70.79 Typical High $85.11 | Professional | 54 · Surgery only | $38.90 | $70.79 | $85.11 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $7.76 Median $14.13 Typical High $16.98 | Professional | 55 · Aftercare only | $7.76 | $14.13 | $16.98 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $5.13 Median $9.55 Typical High $11.48 | Professional | 56 · Pre-op care only | $5.13 | $9.55 | $11.48 |
Where Nevada sits
The same service costs 3.4 times more in Alaska than in Kentucky. 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
$95.50
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.