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 $204.17 Median $3,981.07 Typical High $10,715.19 | Facility | None | $204.17 | $3,981.07 | $10,715.19 |
Aetna Setting Professional Modifier None Typical Low $204.17 Median $208.93 Typical High $223.87 | Professional | None | $204.17 | $208.93 | $223.87 |
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 $181.97 Median $218.78 Typical High $407.38 | Professional | None | $181.97 | $218.78 | $407.38 |
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 $165.96 Median $177.83 Typical High $295.12 | Professional | None | $165.96 | $177.83 | $295.12 |
Hometown Health Setting Professional Modifier None Typical Low $3.09 Median $213.80 Typical High $288.40 | Professional | None | $3.09 | $213.80 | $288.40 |
Hometown Health Setting Professional Modifier None Typical Low $2.63 Median $2.63 Typical High $245.47 | Professional | None | $2.63 | $2.63 | $245.47 |
Select Health Setting Facility Modifier None Typical Low $165.96 Median $165.96 Typical High $4,265.80 | Facility | None | $165.96 | $165.96 | $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 $165.96 Median $245.47 Typical High $316.23 | Professional | None | $165.96 | $245.47 | $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 $102.33 Median $104.71 Typical High $104.71 | Professional | 52 · Reduced service | $102.33 | $104.71 | $104.71 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $40.74 Median $41.69 Typical High $41.69 | Professional | 53 · Discontinued | $40.74 | $41.69 | $41.69 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $154.88 Median $154.88 Typical High $154.88 | Professional | 54 · Surgery only | $154.88 | $154.88 | $154.88 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $30.90 Median $30.90 Typical High $30.90 | Professional | 55 · Aftercare only | $30.90 | $30.90 | $30.90 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $20.42 Median $20.89 Typical High $20.89 | Professional | 56 · Pre-op care only | $20.42 | $20.89 | $20.89 |
Where Nevada sits
The same service costs 4.3 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· 31st of 51
$295
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.