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 $15.14 Median $3,981.07 Typical High $10,715.19 | Facility | None | $15.14 | $3,981.07 | $10,715.19 |
Aetna Setting Professional Modifier None Typical Low $12.02 Median $15.14 Typical High $17.38 | Professional | None | $12.02 | $15.14 | $17.38 |
Anthem BCBS Setting Facility Modifier None Typical Low $8.91 Median $14.45 Typical High $14.45 | Facility | None | $8.91 | $14.45 | $14.45 |
Anthem BCBS Setting Professional Modifier None Typical Low $12.88 Median $12.88 Typical High $27.54 | Professional | None | $12.88 | $12.88 | $27.54 |
Cigna Setting Professional Modifier None Typical Low $10.72 Median $10.72 Typical High $14.45 | Professional | None | $10.72 | $10.72 | $14.45 |
Hometown Health Setting Professional Modifier None Typical Low $0.09 Median $12.59 Typical High $18.20 | Professional | None | $0.09 | $12.59 | $18.20 |
Hometown Health Setting Professional Modifier None Typical Low $0.09 Median $0.09 Typical High $16.98 | Professional | None | $0.09 | $0.09 | $16.98 |
Select Health Setting Facility Modifier None Typical Low $11.48 Median $11.48 Typical High $4,265.80 | Facility | None | $11.48 | $11.48 | $4,265.80 |
Select Health Setting Professional Modifier None Typical Low $8.71 Median $8.71 Typical High $11.48 | Professional | None | $8.71 | $8.71 | $11.48 |
United Setting Professional Modifier None Typical Low $10.00 Median $14.13 Typical High $19.05 | Professional | None | $10.00 | $14.13 | $19.05 |
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 $6.76 Median $7.59 Typical High $8.51 | Professional | 52 · Reduced service | $6.76 | $7.59 | $8.51 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $2.75 Median $3.02 Typical High $3.47 | Professional | 53 · Discontinued | $2.75 | $3.02 | $3.47 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $10.23 Median $11.22 Typical High $12.88 | Professional | 54 · Surgery only | $10.23 | $11.22 | $12.88 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $2.04 Median $2.24 Typical High $2.57 | Professional | 55 · Aftercare only | $2.04 | $2.24 | $2.57 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $1.35 Median $1.51 Typical High $1.74 | Professional | 56 · Pre-op care only | $1.35 | $1.51 | $1.74 |
Where Nevada sits
The same service costs 3.3 times more in Alaska than in Delaware. 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· 46th of 51
$12.88
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.