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 $44.67 Median $1,698.24 Typical High $4,365.16 | Facility | None | $44.67 | $1,698.24 | $4,365.16 |
Aetna Setting Professional Modifier None Typical Low $44.67 Median $79.43 Typical High $81.28 | Professional | None | $44.67 | $79.43 | $81.28 |
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 $43.65 Median $51.29 Typical High $93.33 | Professional | None | $43.65 | $51.29 | $93.33 |
Cigna Setting Facility Modifier None Typical Low $54.95 Median $67.61 Typical High $549.54 | Facility | None | $54.95 | $67.61 | $549.54 |
Cigna Setting Professional Modifier None Typical Low $54.95 Median $89.13 Typical High $151.36 | Professional | None | $54.95 | $89.13 | $151.36 |
Hometown Health Setting Professional Modifier None Typical Low $50.12 Median $69.18 Typical High $125.89 | Professional | None | $50.12 | $69.18 | $125.89 |
Hometown Health Setting Facility Modifier None Typical Low $54.95 Median $54.95 Typical High $54.95 | Facility | None | $54.95 | $54.95 | $54.95 |
Hometown Health Setting Professional Modifier None Typical Low $0.72 Median $57.54 Typical High $120.23 | Professional | None | $0.72 | $57.54 | $120.23 |
Select Health Setting Facility Modifier None Typical Low $38.02 Median $79.43 Typical High $4,265.80 | Facility | None | $38.02 | $79.43 | $4,265.80 |
Select Health Setting Professional Modifier None Typical Low $30.20 Median $57.54 Typical High $75.86 | Professional | None | $30.20 | $57.54 | $75.86 |
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 $50.12 Median $89.13 Typical High $144.54 | Professional | None | $50.12 | $89.13 | $144.54 |
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 $22.39 Median $39.81 Typical High $40.74 | Professional | 52 · Reduced service | $22.39 | $39.81 | $40.74 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $8.91 Median $15.85 Typical High $16.22 | Professional | 53 · Discontinued | $8.91 | $15.85 | $16.22 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $33.88 Median $60.26 Typical High $61.66 | Professional | 54 · Surgery only | $33.88 | $60.26 | $61.66 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $6.76 Median $12.02 Typical High $12.30 | Professional | 55 · Aftercare only | $6.76 | $12.02 | $12.30 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $4.47 Median $7.94 Typical High $8.13 | Professional | 56 · Pre-op care only | $4.47 | $7.94 | $8.13 |
Where Nevada sits
The same service costs 3.0 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· 44th of 51
$81.28
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.