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 $53.70 Median $1,698.24 Typical High $4,365.16 | Facility | None | $53.70 | $1,698.24 | $4,365.16 |
Aetna Setting Professional Modifier None Typical Low $53.70 Median $109.65 Typical High $114.82 | Professional | None | $53.70 | $109.65 | $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 $53.70 Median $61.66 Typical High $100.00 | Professional | None | $53.70 | $61.66 | $100.00 |
Cigna Setting Facility Modifier None Typical Low $89.13 Median $112.20 Typical High $549.54 | Facility | None | $89.13 | $112.20 | $549.54 |
Cigna Setting Professional Modifier None Typical Low $67.61 Median $112.20 Typical High $165.96 | Professional | None | $67.61 | $112.20 | $165.96 |
Hometown Health Setting Professional Modifier None Typical Low $64.57 Median $97.72 Typical High $162.18 | Professional | None | $64.57 | $97.72 | $162.18 |
Hometown Health Setting Facility Modifier None Typical Low $89.13 Median $89.13 Typical High $89.13 | Facility | None | $89.13 | $89.13 | $89.13 |
Hometown Health Setting Professional Modifier None Typical Low $0.89 Median $74.13 Typical High $181.97 | Professional | None | $0.89 | $74.13 | $181.97 |
Select Health Setting Facility Modifier None Typical Low $48.98 Median $120.23 Typical High $4,265.80 | Facility | None | $48.98 | $120.23 | $4,265.80 |
Select Health Setting Professional Modifier None Typical Low $39.81 Median $74.13 Typical High $114.82 | Professional | None | $39.81 | $74.13 | $114.82 |
United Setting Facility Modifier None Typical Low $302.00 Median $512.86 Typical High $2,137.96 | Facility | None | $302.00 | $512.86 | $2,137.96 |
United Setting Professional Modifier None Typical Low $64.57 Median $109.65 Typical High $177.83 | Professional | None | $64.57 | $109.65 | $177.83 |
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 $26.92 Median $47.86 Typical High $54.95 | Professional | 52 · Reduced service | $26.92 | $47.86 | $54.95 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $10.96 Median $19.05 Typical High $22.39 | Professional | 53 · Discontinued | $10.96 | $19.05 | $22.39 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $40.74 Median $72.44 Typical High $83.18 | Professional | 54 · Surgery only | $40.74 | $72.44 | $83.18 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $8.13 Median $14.45 Typical High $16.60 | Professional | 55 · Aftercare only | $8.13 | $14.45 | $16.60 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $5.37 Median $9.55 Typical High $10.96 | Professional | 56 · Pre-op care only | $5.37 | $9.55 | $10.96 |
Where Nevada sits
The same service costs 3.2 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· 40th of 51
$107
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.