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 $64.57 Median $2,137.96 Typical High $10,715.19 | Facility | None | $64.57 | $2,137.96 | $10,715.19 |
Aetna Setting Professional Modifier None Typical Low $64.57 Median $77.62 Typical High $93.33 | Professional | None | $64.57 | $77.62 | $93.33 |
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 $60.26 Median $70.79 Typical High $100.00 | Professional | None | $60.26 | $70.79 | $100.00 |
Cigna Setting Facility Modifier None Typical Low $38.02 Median $43.65 Typical High $67.61 | Facility | None | $38.02 | $43.65 | $67.61 |
Cigna Setting Professional Modifier None Typical Low $64.57 Median $89.13 Typical High $138.04 | Professional | None | $64.57 | $89.13 | $138.04 |
Hometown Health Setting Professional Modifier None Typical Low $70.79 Median $81.28 Typical High $128.82 | Professional | None | $70.79 | $81.28 | $128.82 |
Hometown Health Setting Facility Modifier None Typical Low $39.81 Median $39.81 Typical High $39.81 | Facility | None | $39.81 | $39.81 | $39.81 |
Hometown Health Setting Professional Modifier None Typical Low $0.89 Median $58.88 Typical High $117.49 | Professional | None | $0.89 | $58.88 | $117.49 |
Select Health Setting Facility Modifier None Typical Low $54.95 Median $77.62 Typical High $4,265.80 | Facility | None | $54.95 | $77.62 | $4,265.80 |
Select Health Setting Professional Modifier None Typical Low $51.29 Median $77.62 Typical High $117.49 | Professional | None | $51.29 | $77.62 | $117.49 |
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 $74.13 Typical High $123.03 | Professional | None | $48.98 | $74.13 | $123.03 |
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 $32.36 Median $38.90 Typical High $46.77 | Professional | 52 · Reduced service | $32.36 | $38.90 | $46.77 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $12.88 Median $15.49 Typical High $18.62 | Professional | 53 · Discontinued | $12.88 | $15.49 | $18.62 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $47.86 Median $58.88 Typical High $69.18 | Professional | 54 · Surgery only | $47.86 | $58.88 | $69.18 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $9.55 Median $11.75 Typical High $13.80 | Professional | 55 · Aftercare only | $9.55 | $11.75 | $13.80 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $6.46 Median $7.76 Typical High $9.33 | Professional | 56 · Pre-op care only | $6.46 | $7.76 | $9.33 |
Where Nevada sits
The same service costs 3.8 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· 37th of 51
$79.43
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.