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 $47.86 Median $2,137.96 Typical High $10,715.19 | Facility | None | $47.86 | $2,137.96 | $10,715.19 |
Aetna Setting Professional Modifier None Typical Low $47.86 Median $61.66 Typical High $75.86 | Professional | None | $47.86 | $61.66 | $75.86 |
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 $45.71 Median $52.48 Typical High $75.86 | Professional | None | $45.71 | $52.48 | $75.86 |
Cigna Setting Facility Modifier None Typical Low $32.36 Median $38.02 Typical High $66.07 | Facility | None | $32.36 | $38.02 | $66.07 |
Cigna Setting Professional Modifier None Typical Low $51.29 Median $75.86 Typical High $173.78 | Professional | None | $51.29 | $75.86 | $173.78 |
Hometown Health Setting Professional Modifier None Typical Low $51.29 Median $64.57 Typical High $87.10 | Professional | None | $51.29 | $64.57 | $87.10 |
Hometown Health Setting Facility Modifier None Typical Low $34.67 Median $34.67 Typical High $34.67 | Facility | None | $34.67 | $34.67 | $34.67 |
Hometown Health Setting Professional Modifier None Typical Low $0.42 Median $51.29 Typical High $93.33 | Professional | None | $0.42 | $51.29 | $93.33 |
Select Health Setting Facility Modifier None Typical Low $39.81 Median $61.66 Typical High $4,265.80 | Facility | None | $39.81 | $61.66 | $4,265.80 |
Select Health Setting Professional Modifier None Typical Low $37.15 Median $58.88 Typical High $66.07 | Professional | None | $37.15 | $58.88 | $66.07 |
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 $45.71 Median $58.88 Typical High $97.72 | Professional | None | $45.71 | $58.88 | $97.72 |
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 $23.99 Median $29.51 Typical High $38.02 | Professional | 52 · Reduced service | $23.99 | $29.51 | $38.02 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $9.77 Median $12.02 Typical High $15.14 | Professional | 53 · Discontinued | $9.77 | $12.02 | $15.14 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $36.31 Median $44.67 Typical High $56.23 | Professional | 54 · Surgery only | $36.31 | $44.67 | $56.23 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $7.24 Median $8.91 Typical High $11.22 | Professional | 55 · Aftercare only | $7.24 | $8.91 | $11.22 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $4.79 Median $6.03 Typical High $7.59 | Professional | 56 · Pre-op care only | $4.79 | $6.03 | $7.59 |
Where Nevada sits
The same service costs 3.7 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· 39th of 51
$63.10
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.