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 $147.91 Median $2,238.72 Typical High $5,011.87 | Facility | None | $147.91 | $2,238.72 | $5,011.87 |
Aetna Setting Professional Modifier None Typical Low $141.25 Median $251.19 Typical High $302.00 | Professional | None | $141.25 | $251.19 | $302.00 |
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 $131.83 Median $275.42 Typical High $457.09 | Professional | None | $131.83 | $275.42 | $457.09 |
Cigna Setting Facility Modifier None Typical Low $223.87 Median $281.84 Typical High $724.44 | Facility | None | $223.87 | $281.84 | $724.44 |
Cigna Setting Professional Modifier None Typical Low $117.49 Median $229.09 Typical High $380.19 | Professional | None | $117.49 | $229.09 | $380.19 |
Hometown Health Setting Professional Modifier None Typical Low $123.03 Median $245.47 Typical High $416.87 | Professional | None | $123.03 | $245.47 | $416.87 |
Hometown Health Setting Facility Modifier None Typical Low $223.87 Median $223.87 Typical High $223.87 | Facility | None | $223.87 | $223.87 | $223.87 |
Hometown Health Setting Professional Modifier None Typical Low $1.55 Median $173.78 Typical High $407.38 | Professional | None | $1.55 | $173.78 | $407.38 |
Select Health Setting Facility Modifier None Typical Low $114.82 Median $269.15 Typical High $4,265.80 | Facility | None | $114.82 | $269.15 | $4,265.80 |
Select Health Setting Professional Modifier None Typical Low $245.47 Median $245.47 Typical High $245.47 | Professional | None | $245.47 | $245.47 | $245.47 |
United Setting Facility Modifier None Typical Low $97.72 Median $245.47 Typical High $1,949.84 | Facility | None | $97.72 | $245.47 | $1,949.84 |
United Setting Professional Modifier None Typical Low $134.90 Median $257.04 Typical High $380.19 | Professional | None | $134.90 | $257.04 | $380.19 |
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 $70.79 Median $123.03 Typical High $151.36 | Professional | 52 · Reduced service | $70.79 | $123.03 | $151.36 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $28.18 Median $48.98 Typical High $60.26 | Professional | 53 · Discontinued | $28.18 | $48.98 | $60.26 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $104.71 Median $181.97 Typical High $229.09 | Professional | 54 · Surgery only | $104.71 | $181.97 | $229.09 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $21.38 Median $37.15 Typical High $45.71 | Professional | 55 · Aftercare only | $21.38 | $37.15 | $45.71 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $14.13 Median $24.55 Typical High $30.20 | Professional | 56 · Pre-op care only | $14.13 | $24.55 | $30.20 |
Where Nevada sits
The same service costs 3.2 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· 32nd of 51
$269
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.