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 $831.76 Median $3,981.07 Typical High $10,715.19 | Facility | None | $831.76 | $3,981.07 | $10,715.19 |
Aetna Setting Professional Modifier None Typical Low $831.76 Median $831.76 Typical High $912.01 | Professional | None | $831.76 | $831.76 | $912.01 |
Anthem BCBS Setting Facility Modifier None Typical Low $4,897.79 Median $8,128.31 Typical High $11,220.18 | Facility | None | $4,897.79 | $8,128.31 | $11,220.18 |
Anthem BCBS Setting Professional Modifier None Typical Low $724.44 Median $870.96 Typical High $1,621.81 | Professional | None | $724.44 | $870.96 | $1,621.81 |
Cigna Setting Facility Modifier None Typical Low $562.34 Median $758.58 Typical High $2,137.96 | Facility | None | $562.34 | $758.58 | $2,137.96 |
Cigna Setting Professional Modifier None Typical Low $630.96 Median $691.83 Typical High $1,202.26 | Professional | None | $630.96 | $691.83 | $1,202.26 |
Hometown Health Setting Professional Modifier None Typical Low $10.96 Median $831.76 Typical High $1,148.15 | Professional | None | $10.96 | $831.76 | $1,148.15 |
Hometown Health Setting Professional Modifier None Typical Low $9.55 Median $9.55 Typical High $977.24 | Professional | None | $9.55 | $9.55 | $977.24 |
Select Health Setting Facility Modifier None Typical Low $660.69 Median $660.69 Typical High $4,265.80 | Facility | None | $660.69 | $660.69 | $4,265.80 |
United Setting Facility Modifier None Typical Low $302.00 Median $794.33 Typical High $2,951.21 | Facility | None | $302.00 | $794.33 | $2,951.21 |
United Setting Professional Modifier None Typical Low $630.96 Median $933.25 Typical High $1,288.25 | Professional | None | $630.96 | $933.25 | $1,288.25 |
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 $416.87 Median $416.87 Typical High $416.87 | Professional | 52 · Reduced service | $416.87 | $416.87 | $416.87 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $165.96 Median $165.96 Typical High $165.96 | Professional | 53 · Discontinued | $165.96 | $165.96 | $165.96 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $616.60 Median $630.96 Typical High $630.96 | Professional | 54 · Surgery only | $616.60 | $630.96 | $630.96 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $123.03 Median $125.89 Typical High $125.89 | Professional | 55 · Aftercare only | $123.03 | $125.89 | $125.89 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $83.18 Median $83.18 Typical High $83.18 | Professional | 56 · Pre-op care only | $83.18 | $83.18 | $83.18 |
Where Nevada sits
The same service costs 3.8 times more in Wisconsin 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· 37th of 51
$933
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.