How much rates vary
Distribution of negotiated rates across all payers (price axis is log-scale). Small sample; interpret with caution. 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 $812.83 Median $812.83 Typical High $2,089.30 | Facility | None | $812.83 | $812.83 | $2,089.30 |
Aetna Setting Professional Modifier None Typical Low $812.83 Median $812.83 Typical High $2,089.30 | Professional | None | $812.83 | $812.83 | $2,089.30 |
Anthem BCBS Setting Facility Modifier None Typical Low $2,570.40 Median $2,691.53 Typical High $3,630.78 | Facility | None | $2,570.40 | $2,691.53 | $3,630.78 |
Anthem BCBS Setting Professional Modifier None Typical Low $1,412.54 Median $1,412.54 Typical High $1,412.54 | Professional | None | $1,412.54 | $1,412.54 | $1,412.54 |
Cigna Setting Facility Modifier None Typical Low $1,659.59 Median $1,659.59 Typical High $1,778.28 | Facility | None | $1,659.59 | $1,659.59 | $1,778.28 |
Cigna Setting Professional Modifier None Typical Low $1,202.26 Median $1,202.26 Typical High $1,862.09 | Professional | None | $1,202.26 | $1,202.26 | $1,862.09 |
Hometown Health Setting Professional Modifier None Typical Low $1,479.11 Median $2,344.23 Typical High $4,365.16 | Professional | None | $1,479.11 | $2,344.23 | $4,365.16 |
Select Health Setting Facility Modifier None Typical Low $2,570.40 Median $2,570.40 Typical High $4,265.80 | Facility | None | $2,570.40 | $2,570.40 | $4,265.80 |
Select Health Setting Professional Modifier None Typical Low $1,659.59 Median $2,344.23 Typical High $2,691.53 | Professional | None | $1,659.59 | $2,344.23 | $2,691.53 |
United Setting Facility Modifier None Typical Low $977.24 Median $977.24 Typical High $1,258.93 | Facility | None | $977.24 | $977.24 | $1,258.93 |
United Setting Professional Modifier None Typical Low $1,096.48 Median $1,621.81 Typical High $2,570.40 | Professional | None | $1,096.48 | $1,621.81 | $2,570.40 |
6 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 $407.38 Median $407.38 Typical High $1,047.13 | Professional | 52 · Reduced service | $407.38 | $407.38 | $1,047.13 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $165.96 Median $165.96 Typical High $416.87 | Professional | 53 · Discontinued | $165.96 | $165.96 | $416.87 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $123.03 Median $123.03 Typical High $316.23 | Professional | 55 · Aftercare only | $123.03 | $123.03 | $316.23 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $81.28 Median $81.28 Typical High $208.93 | Professional | 56 · Pre-op care only | $81.28 | $81.28 | $208.93 |
Anthem BCBS Setting Professional Modifier RR · Rental Typical Low $1,380.38 Median $1,412.54 Typical High $1,412.54 | Professional | RR · Rental | $1,380.38 | $1,412.54 | $1,412.54 |
Anthem BCBS Setting Professional Modifier UE · Used equipment Typical Low $1,047.13 Median $1,047.13 Typical High $1,047.13 | Professional | UE · Used equipment | $1,047.13 | $1,047.13 | $1,047.13 |
Where Nevada sits
The same service costs 2.4 times more in Hawaii than in Vermont. 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· 26th of 51
$1,622
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.