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 $72.44 Median $1,698.24 Typical High $4,365.16 | Facility | None | $72.44 | $1,698.24 | $4,365.16 |
Aetna Setting Professional Modifier None Typical Low $69.18 Median $141.25 Typical High $158.49 | Professional | None | $69.18 | $141.25 | $158.49 |
Anthem BCBS Setting Professional Modifier None Typical Low $72.44 Median $158.49 Typical High $275.42 | Professional | None | $72.44 | $158.49 | $275.42 |
Cigna Setting Professional Modifier None Typical Low $63.10 Median $134.90 Typical High $302.00 | Professional | None | $63.10 | $134.90 | $302.00 |
Hometown Health Setting Professional Modifier None Typical Low $63.10 Median $123.03 Typical High $245.47 | Professional | None | $63.10 | $123.03 | $245.47 |
Hometown Health Setting Professional Modifier None Typical Low $0.42 Median $95.50 Typical High $239.88 | Professional | None | $0.42 | $95.50 | $239.88 |
Select Health Setting Facility Modifier None Typical Low $63.10 Median $158.49 Typical High $4,265.80 | Facility | None | $63.10 | $158.49 | $4,265.80 |
Select Health Setting Professional Modifier None Typical Low $48.98 Median $48.98 Typical High $63.10 | Professional | None | $48.98 | $48.98 | $63.10 |
United Setting Facility Modifier None Typical Low $251.19 Median $1,412.54 Typical High $2,041.74 | Facility | None | $251.19 | $1,412.54 | $2,041.74 |
United Setting Professional Modifier None Typical Low $64.57 Median $158.49 Typical High $251.19 | Professional | None | $64.57 | $158.49 | $251.19 |
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 $33.88 Median $58.88 Typical High $79.43 | Professional | 52 · Reduced service | $33.88 | $58.88 | $79.43 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $13.80 Median $23.44 Typical High $31.62 | Professional | 53 · Discontinued | $13.80 | $23.44 | $31.62 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $51.29 Median $89.13 Typical High $120.23 | Professional | 54 · Surgery only | $51.29 | $89.13 | $120.23 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $10.23 Median $17.78 Typical High $23.99 | Professional | 55 · Aftercare only | $10.23 | $17.78 | $23.99 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $6.92 Median $11.75 Typical High $15.85 | Professional | 56 · Pre-op care only | $6.92 | $11.75 | $15.85 |
Anthem BCBS Setting Professional Modifier 50 · Both sides Typical Low $93.33 Median $194.98 Typical High $251.19 | Professional | 50 · Both sides | $93.33 | $194.98 | $251.19 |
Where Nevada sits
The same service costs 2.6 times more in Wisconsin than in Utah. 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· 37th of 51
$151
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.