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 $870.96 Median $870.96 Typical High $2,238.72 | Facility | None | $870.96 | $870.96 | $2,238.72 |
Aetna Setting Professional Modifier None Typical Low $870.96 Median $870.96 Typical High $2,238.72 | Professional | None | $870.96 | $870.96 | $2,238.72 |
Anthem BCBS Setting Professional Modifier None Typical Low $851.14 Median $1,122.02 Typical High $3,019.95 | Professional | None | $851.14 | $1,122.02 | $3,019.95 |
Cigna Setting Facility Modifier None Typical Low $1,479.11 Median $1,479.11 Typical High $1,584.89 | Facility | None | $1,479.11 | $1,479.11 | $1,584.89 |
Cigna Setting Professional Modifier None Typical Low $1,174.90 Median $1,258.93 Typical High $1,479.11 | Professional | None | $1,174.90 | $1,258.93 | $1,479.11 |
Hometown Health Setting Professional Modifier None Typical Low $1,548.82 Median $2,454.71 Typical High $4,677.35 | Professional | None | $1,548.82 | $2,454.71 | $4,677.35 |
Select Health Setting Facility Modifier None Typical Low $2,754.23 Median $2,754.23 Typical High $4,265.80 | Facility | None | $2,754.23 | $2,754.23 | $4,265.80 |
Select Health Setting Professional Modifier None Typical Low $1,737.80 Median $2,454.71 Typical High $2,754.23 | Professional | None | $1,737.80 | $2,454.71 | $2,754.23 |
United Setting Professional Modifier None Typical Low $1,122.02 Median $1,698.24 Typical High $2,754.23 | Professional | None | $1,122.02 | $1,698.24 | $2,754.23 |
4 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 $436.52 Median $436.52 Typical High $1,122.02 | Professional | 52 · Reduced service | $436.52 | $436.52 | $1,122.02 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $173.78 Median $173.78 Typical High $446.68 | Professional | 53 · Discontinued | $173.78 | $173.78 | $446.68 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $131.83 Median $131.83 Typical High $338.84 | Professional | 55 · Aftercare only | $131.83 | $131.83 | $338.84 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $87.10 Median $87.10 Typical High $223.87 | Professional | 56 · Pre-op care only | $87.10 | $87.10 | $223.87 |
Where Nevada sits
The same service costs 2.6 times more in Montana than in New York. 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· 30th of 51
$1,479
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.