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 $128.82 Median $3,981.07 Typical High $5,248.07 | Facility | None | $128.82 | $3,981.07 | $5,248.07 |
Aetna Setting Professional Modifier None Typical Low $123.03 Median $229.09 Typical High $302.00 | Professional | None | $123.03 | $229.09 | $302.00 |
Ambetter Setting Professional Modifier None Typical Low $478.63 Median $478.63 Typical High $478.63 | Professional | None | $478.63 | $478.63 | $478.63 |
Anthem BCBS Setting Facility Modifier None Typical Low $2,570.40 Median $3,801.89 Typical High $5,128.61 | Facility | None | $2,570.40 | $3,801.89 | $5,128.61 |
Anthem BCBS Setting Professional Modifier None Typical Low $120.23 Median $229.09 Typical High $380.19 | Professional | None | $120.23 | $229.09 | $380.19 |
Cigna Setting Facility Modifier None Typical Low $154.88 Median $190.55 Typical High $933.25 | Facility | None | $154.88 | $190.55 | $933.25 |
Cigna Setting Professional Modifier None Typical Low $165.96 Median $181.97 Typical High $537.03 | Professional | None | $165.96 | $181.97 | $537.03 |
Hometown Health Setting Professional Modifier None Typical Low $16.98 Median $177.83 Typical High $346.74 | Professional | None | $16.98 | $177.83 | $346.74 |
Hometown Health Setting Facility Modifier None Typical Low $154.88 Median $154.88 Typical High $154.88 | Facility | None | $154.88 | $154.88 | $154.88 |
Hometown Health Setting Professional Modifier None Typical Low $12.59 Median $158.49 Typical High $331.13 | Professional | None | $12.59 | $158.49 | $331.13 |
Select Health Setting Facility Modifier None Typical Low $107.15 Median $223.87 Typical High $4,265.80 | Facility | None | $107.15 | $223.87 | $4,265.80 |
Select Health Setting Professional Modifier None Typical Low $199.53 Median $199.53 Typical High $199.53 | Professional | None | $199.53 | $199.53 | $199.53 |
United Setting Facility Modifier None Typical Low $467.74 Median $724.44 Typical High $2,884.03 | Facility | None | $467.74 | $724.44 | $2,884.03 |
United Setting Professional Modifier None Typical Low $123.03 Median $223.87 Typical High $870.96 | Professional | None | $123.03 | $223.87 | $870.96 |
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 $61.66 Median $95.50 Typical High $117.49 | Professional | 52 · Reduced service | $61.66 | $95.50 | $117.49 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $24.55 Median $38.90 Typical High $46.77 | Professional | 53 · Discontinued | $24.55 | $38.90 | $46.77 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $93.33 Median $144.54 Typical High $177.83 | Professional | 54 · Surgery only | $93.33 | $144.54 | $177.83 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $18.62 Median $28.84 Typical High $35.48 | Professional | 55 · Aftercare only | $18.62 | $28.84 | $35.48 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $12.30 Median $19.05 Typical High $23.44 | Professional | 56 · Pre-op care only | $12.30 | $19.05 | $23.44 |
Where Nevada sits
The same service costs 3.2 times more in Oklahoma than in Texas. 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
$229
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.