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 $117.49 Median $1,698.24 Typical High $4,365.16 | Facility | None | $117.49 | $1,698.24 | $4,365.16 |
Aetna Setting Professional Modifier None Typical Low $114.82 Median $154.88 Typical High $158.49 | Professional | None | $114.82 | $154.88 | $158.49 |
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 $112.20 Median $128.82 Typical High $213.80 | Professional | None | $112.20 | $128.82 | $213.80 |
Cigna Setting Facility Modifier None Typical Low $95.50 Median $120.23 Typical High $912.01 | Facility | None | $95.50 | $120.23 | $912.01 |
Cigna Setting Professional Modifier None Typical Low $93.33 Median $131.83 Typical High $208.93 | Professional | None | $93.33 | $131.83 | $208.93 |
Hometown Health Setting Professional Modifier None Typical Low $79.43 Median $125.89 Typical High $208.93 | Professional | None | $79.43 | $125.89 | $208.93 |
Hometown Health Setting Facility Modifier None Typical Low $100.00 Median $100.00 Typical High $100.00 | Facility | None | $100.00 | $100.00 | $100.00 |
Hometown Health Setting Professional Modifier None Typical Low $0.89 Median $151.36 Typical High $251.19 | Professional | None | $0.89 | $151.36 | $251.19 |
Select Health Setting Facility Modifier None Typical Low $102.33 Median $165.96 Typical High $4,265.80 | Facility | None | $102.33 | $165.96 | $4,265.80 |
Select Health Setting Professional Modifier None Typical Low $81.28 Median $134.90 Typical High $165.96 | Professional | None | $81.28 | $134.90 | $165.96 |
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 $114.82 Median $158.49 Typical High $229.09 | Professional | None | $114.82 | $158.49 | $229.09 |
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 $58.88 Median $70.79 Typical High $79.43 | Professional | 52 · Reduced service | $58.88 | $70.79 | $79.43 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $23.44 Median $28.18 Typical High $32.36 | Professional | 53 · Discontinued | $23.44 | $28.18 | $32.36 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $87.10 Median $107.15 Typical High $120.23 | Professional | 54 · Surgery only | $87.10 | $107.15 | $120.23 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $17.38 Median $21.38 Typical High $23.99 | Professional | 55 · Aftercare only | $17.38 | $21.38 | $23.99 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $11.75 Median $14.13 Typical High $15.85 | Professional | 56 · Pre-op care only | $11.75 | $14.13 | $15.85 |
Where Nevada sits
The same service costs 3.5 times more in Alaska than in Florida. 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
$148
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.