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 $524.81 Median $3,981.07 Typical High $10,715.19 | Facility | None | $524.81 | $3,981.07 | $10,715.19 |
Aetna Setting Professional Modifier None Typical Low $524.81 Median $537.03 Typical High $630.96 | Professional | None | $524.81 | $537.03 | $630.96 |
Anthem BCBS Setting Facility Modifier None Typical Low $2,570.40 Median $3,801.89 Typical High $5,128.61 | Facility | None | $2,570.40 | $3,801.89 | $5,128.61 |
Anthem BCBS Setting Professional Modifier None Typical Low $457.09 Median $562.34 Typical High $1,023.29 | Professional | None | $457.09 | $562.34 | $1,023.29 |
Cigna Setting Facility Modifier None Typical Low $562.34 Median $912.01 Typical High $6,309.57 | Facility | None | $562.34 | $912.01 | $6,309.57 |
Cigna Setting Professional Modifier None Typical Low $407.38 Median $446.68 Typical High $758.58 | Professional | None | $407.38 | $446.68 | $758.58 |
Hometown Health Setting Professional Modifier None Typical Low $7.94 Median $549.54 Typical High $741.31 | Professional | None | $7.94 | $549.54 | $741.31 |
Hometown Health Setting Professional Modifier None Typical Low $6.92 Median $6.92 Typical High $630.96 | Professional | None | $6.92 | $6.92 | $630.96 |
Select Health Setting Facility Modifier None Typical Low $416.87 Median $416.87 Typical High $4,265.80 | Facility | None | $416.87 | $416.87 | $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 $416.87 Median $549.54 Typical High $812.83 | Professional | None | $416.87 | $549.54 | $812.83 |
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 $263.03 Median $269.15 Typical High $269.15 | Professional | 52 · Reduced service | $263.03 | $269.15 | $269.15 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $104.71 Median $107.15 Typical High $107.15 | Professional | 53 · Discontinued | $104.71 | $107.15 | $107.15 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $398.11 Median $398.11 Typical High $398.11 | Professional | 54 · Surgery only | $398.11 | $398.11 | $398.11 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $79.43 Median $79.43 Typical High $79.43 | Professional | 55 · Aftercare only | $79.43 | $79.43 | $79.43 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $52.48 Median $53.70 Typical High $53.70 | Professional | 56 · Pre-op care only | $52.48 | $53.70 | $53.70 |
Where Nevada sits
The same service costs 4.0 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· 36th of 51
$661
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.