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 $281.84 Median $2,238.72 Typical High $5,011.87 | Facility | None | $281.84 | $2,238.72 | $5,011.87 |
Aetna Setting Professional Modifier None Typical Low $281.84 Median $1,348.96 Typical High $1,548.82 | Professional | None | $281.84 | $1,348.96 | $1,548.82 |
Anthem BCBS Setting Facility Modifier None Typical Low $2,754.23 Median $4,466.84 Typical High $5,754.40 | Facility | None | $2,754.23 | $4,466.84 | $5,754.40 |
Anthem BCBS Setting Professional Modifier None Typical Low $251.19 Median $1,122.02 Typical High $2,238.72 | Professional | None | $251.19 | $1,122.02 | $2,238.72 |
Cigna Setting Professional Modifier None Typical Low $234.42 Median $1,230.27 Typical High $2,137.96 | Professional | None | $234.42 | $1,230.27 | $2,137.96 |
Hometown Health Setting Professional Modifier None Typical Low $234.42 Median $436.52 Typical High $1,949.84 | Professional | None | $234.42 | $436.52 | $1,949.84 |
Hometown Health Setting Professional Modifier None Typical Low $4.07 Median $331.13 Typical High $1,819.70 | Professional | None | $4.07 | $331.13 | $1,819.70 |
Select Health Setting Facility Modifier None Typical Low $218.78 Median $1,230.27 Typical High $4,265.80 | Facility | None | $218.78 | $1,230.27 | $4,265.80 |
Select Health Setting Professional Modifier None Typical Low $165.96 Median $165.96 Typical High $218.78 | Professional | None | $165.96 | $165.96 | $218.78 |
United Setting Facility Modifier None Typical Low $1,905.46 Median $4,073.80 Typical High $9,332.54 | Facility | None | $1,905.46 | $4,073.80 | $9,332.54 |
United Setting Professional Modifier None Typical Low $269.15 Median $1,230.27 Typical High $2,187.76 | Professional | None | $269.15 | $1,230.27 | $2,187.76 |
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 $141.25 Median $389.05 Typical High $724.44 | Professional | 52 · Reduced service | $141.25 | $389.05 | $724.44 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $56.23 Median $154.88 Typical High $295.12 | Professional | 53 · Discontinued | $56.23 | $154.88 | $295.12 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $208.93 Median $575.44 Typical High $1,096.48 | Professional | 54 · Surgery only | $208.93 | $575.44 | $1,096.48 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $42.66 Median $114.82 Typical High $218.78 | Professional | 55 · Aftercare only | $42.66 | $114.82 | $218.78 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $28.18 Median $77.62 Typical High $144.54 | Professional | 56 · Pre-op care only | $28.18 | $77.62 | $144.54 |
Where Nevada sits
The same service costs 4.7 times more in Wisconsin than in Nebraska. 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· 27th of 51
$1,259
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.