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 $61.66 Median $2,137.96 Typical High $10,715.19 | Facility | None | $61.66 | $2,137.96 | $10,715.19 |
Aetna Setting Professional Modifier None Typical Low $61.66 Median $107.15 Typical High $123.03 | Professional | None | $61.66 | $107.15 | $123.03 |
Anthem BCBS Setting Facility Modifier None Typical Low $2,238.72 Median $3,548.13 Typical High $4,466.84 | Facility | None | $2,238.72 | $3,548.13 | $4,466.84 |
Anthem BCBS Setting Professional Modifier None Typical Low $57.54 Median $69.18 Typical High $125.89 | Professional | None | $57.54 | $69.18 | $125.89 |
Cigna Setting Facility Modifier None Typical Low $87.10 Median $107.15 Typical High $549.54 | Facility | None | $87.10 | $107.15 | $549.54 |
Cigna Setting Professional Modifier None Typical Low $51.29 Median $95.50 Typical High $154.88 | Professional | None | $51.29 | $95.50 | $154.88 |
Hometown Health Setting Professional Modifier None Typical Low $53.70 Median $100.00 Typical High $165.96 | Professional | None | $53.70 | $100.00 | $165.96 |
Hometown Health Setting Facility Modifier None Typical Low $87.10 Median $87.10 Typical High $87.10 | Facility | None | $87.10 | $87.10 | $87.10 |
Hometown Health Setting Professional Modifier None Typical Low $0.36 Median $79.43 Typical High $165.96 | Professional | None | $0.36 | $79.43 | $165.96 |
Select Health Setting Facility Modifier None Typical Low $53.70 Median $112.20 Typical High $4,265.80 | Facility | None | $53.70 | $112.20 | $4,265.80 |
Select Health Setting Professional Modifier None Typical Low $100.00 Median $100.00 Typical High $100.00 | Professional | None | $100.00 | $100.00 | $100.00 |
United Setting Facility Modifier None Typical Low $97.72 Median $234.42 Typical High $1,949.84 | Facility | None | $97.72 | $234.42 | $1,949.84 |
United Setting Professional Modifier None Typical Low $51.29 Median $100.00 Typical High $158.49 | Professional | None | $51.29 | $100.00 | $158.49 |
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 $30.90 Median $53.70 Typical High $61.66 | Professional | 52 · Reduced service | $30.90 | $53.70 | $61.66 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $12.30 Median $21.38 Typical High $24.55 | Professional | 53 · Discontinued | $12.30 | $21.38 | $24.55 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $45.71 Median $79.43 Typical High $91.20 | Professional | 54 · Surgery only | $45.71 | $79.43 | $91.20 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $9.12 Median $15.85 Typical High $18.20 | Professional | 55 · Aftercare only | $9.12 | $15.85 | $18.20 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $6.17 Median $10.72 Typical High $12.30 | Professional | 56 · Pre-op care only | $6.17 | $10.72 | $12.30 |
Where Nevada sits
The same service costs 3.9 times more in Wisconsin than in Kentucky. 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· 48th of 51
$97.72
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.