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 $3,311.31 Median $3,311.31 Typical High $8,511.38 | Facility | None | $3,311.31 | $3,311.31 | $8,511.38 |
Aetna Setting Professional Modifier None Typical Low $3,311.31 Median $3,311.31 Typical High $8,511.38 | Professional | None | $3,311.31 | $3,311.31 | $8,511.38 |
Anthem BCBS Setting Professional Modifier None Typical Low $3,235.94 Median $3,801.89 Typical High $4,897.79 | Professional | None | $3,235.94 | $3,801.89 | $4,897.79 |
Cigna Setting Facility Modifier None Typical Low $5,623.41 Median $5,623.41 Typical High $6,025.60 | Facility | None | $5,623.41 | $5,623.41 | $6,025.60 |
Cigna Setting Professional Modifier None Typical Low $4,786.30 Median $4,786.30 Typical High $5,623.41 | Professional | None | $4,786.30 | $4,786.30 | $5,623.41 |
Hometown Health Setting Professional Modifier None Typical Low $6,918.31 Median $10,232.93 Typical High $17,782.79 | Professional | None | $6,918.31 | $10,232.93 | $17,782.79 |
Select Health Setting Facility Modifier None Typical Low $4,265.80 Median $10,471.29 Typical High $10,471.29 | Facility | None | $4,265.80 | $10,471.29 | $10,471.29 |
Select Health Setting Professional Modifier None Typical Low $6,760.83 Median $9,549.93 Typical High $10,471.29 | Professional | None | $6,760.83 | $9,549.93 | $10,471.29 |
United Setting Professional Modifier None Typical Low $4,365.16 Median $7,079.46 Typical High $11,220.18 | Professional | None | $4,365.16 | $7,079.46 | $11,220.18 |
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 $1,659.59 Median $1,659.59 Typical High $4,265.80 | Professional | 52 · Reduced service | $1,659.59 | $1,659.59 | $4,265.80 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $676.08 Median $676.08 Typical High $1,698.24 | Professional | 53 · Discontinued | $676.08 | $676.08 | $1,698.24 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $501.19 Median $501.19 Typical High $1,288.25 | Professional | 55 · Aftercare only | $501.19 | $501.19 | $1,288.25 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $331.13 Median $331.13 Typical High $851.14 | Professional | 56 · Pre-op care only | $331.13 | $331.13 | $851.14 |
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· 24th of 51
$6,026
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.