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 $131.83 Median $2,238.72 Typical High $5,011.87 | Facility | None | $131.83 | $2,238.72 | $5,011.87 |
Aetna Setting Professional Modifier None Typical Low $123.03 Median $208.93 Typical High $245.47 | Professional | None | $123.03 | $208.93 | $245.47 |
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 $117.49 Median $194.98 Typical High $331.13 | Professional | None | $117.49 | $194.98 | $331.13 |
Cigna Setting Facility Modifier None Typical Low $131.83 Median $165.96 Typical High $549.54 | Facility | None | $131.83 | $165.96 | $549.54 |
Cigna Setting Professional Modifier None Typical Low $120.23 Median $181.97 Typical High $288.40 | Professional | None | $120.23 | $181.97 | $288.40 |
Hometown Health Setting Professional Modifier None Typical Low $120.23 Median $173.78 Typical High $309.03 | Professional | None | $120.23 | $173.78 | $309.03 |
Hometown Health Setting Facility Modifier None Typical Low $131.83 Median $131.83 Typical High $131.83 | Facility | None | $131.83 | $131.83 | $131.83 |
Hometown Health Setting Professional Modifier None Typical Low $1.26 Median $154.88 Typical High $288.40 | Professional | None | $1.26 | $154.88 | $288.40 |
Select Health Setting Facility Modifier None Typical Low $102.33 Median $194.98 Typical High $4,265.80 | Facility | None | $102.33 | $194.98 | $4,265.80 |
Select Health Setting Professional Modifier None Typical Low $173.78 Median $173.78 Typical High $173.78 | Professional | None | $173.78 | $173.78 | $173.78 |
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 $120.23 Median $190.55 Typical High $316.23 | Professional | None | $120.23 | $190.55 | $316.23 |
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 $61.66 Median $102.33 Typical High $109.65 | Professional | 52 · Reduced service | $61.66 | $102.33 | $109.65 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $24.55 Median $40.74 Typical High $43.65 | Professional | 53 · Discontinued | $24.55 | $40.74 | $43.65 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $93.33 Median $151.36 Typical High $162.18 | Professional | 54 · Surgery only | $93.33 | $151.36 | $162.18 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $18.62 Median $30.20 Typical High $33.11 | Professional | 55 · Aftercare only | $18.62 | $30.20 | $33.11 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $12.30 Median $20.42 Typical High $21.88 | Professional | 56 · Pre-op care only | $12.30 | $20.42 | $21.88 |
Where Nevada sits
The same service costs 3.0 times more in Wisconsin than in Maryland. 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· 44th of 51
$195
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.