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 $42.66 Median $1,698.24 Typical High $4,365.16 | Facility | None | $42.66 | $1,698.24 | $4,365.16 |
Aetna Setting Professional Modifier None Typical Low $42.66 Median $79.43 Typical High $81.28 | Professional | None | $42.66 | $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 $42.66 Median $48.98 Typical High $87.10 | Professional | None | $42.66 | $48.98 | $87.10 |
Cigna Setting Facility Modifier None Typical Low $48.98 Median $60.26 Typical High $549.54 | Facility | None | $48.98 | $60.26 | $549.54 |
Cigna Setting Professional Modifier None Typical Low $70.79 Median $117.49 Typical High $169.82 | Professional | None | $70.79 | $117.49 | $169.82 |
Hometown Health Setting Professional Modifier None Typical Low $47.86 Median $93.33 Typical High $151.36 | Professional | None | $47.86 | $93.33 | $151.36 |
Hometown Health Setting Facility Modifier None Typical Low $48.98 Median $48.98 Typical High $48.98 | Facility | None | $48.98 | $48.98 | $48.98 |
Hometown Health Setting Professional Modifier None Typical Low $0.89 Median $57.54 Typical High $112.20 | Professional | None | $0.89 | $57.54 | $112.20 |
Select Health Setting Facility Modifier None Typical Low $38.02 Median $74.13 Typical High $4,265.80 | Facility | None | $38.02 | $74.13 | $4,265.80 |
Select Health Setting Professional Modifier None Typical Low $30.20 Median $57.54 Typical High $70.79 | Professional | None | $30.20 | $57.54 | $70.79 |
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 $50.12 Median $89.13 Typical High $186.21 | Professional | None | $50.12 | $89.13 | $186.21 |
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 $21.38 Median $39.81 Typical High $40.74 | Professional | 52 · Reduced service | $21.38 | $39.81 | $40.74 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $8.71 Median $15.85 Typical High $16.22 | Professional | 53 · Discontinued | $8.71 | $15.85 | $16.22 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $32.36 Median $58.88 Typical High $60.26 | Professional | 54 · Surgery only | $32.36 | $58.88 | $60.26 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $6.46 Median $12.02 Typical High $12.02 | Professional | 55 · Aftercare only | $6.46 | $12.02 | $12.02 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $4.37 Median $7.94 Typical High $8.13 | Professional | 56 · Pre-op care only | $4.37 | $7.94 | $8.13 |
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
$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.