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 $16.98 Median $17.38 Typical High $31.62 | Facility | None | $16.98 | $17.38 | $31.62 |
Aetna Setting Professional Modifier None Typical Low $16.98 Median $28.18 Typical High $33.88 | Professional | None | $16.98 | $28.18 | $33.88 |
Anthem BCBS Setting Facility Modifier None Typical Low $3,235.94 Median $6,760.83 Typical High $12,589.25 | Facility | None | $3,235.94 | $6,760.83 | $12,589.25 |
Anthem BCBS Setting Professional Modifier None Typical Low $15.14 Median $25.70 Typical High $46.77 | Professional | None | $15.14 | $25.70 | $46.77 |
Cigna Setting Facility Modifier None Typical Low $54.95 Median $741.31 Typical High $2,137.96 | Facility | None | $54.95 | $741.31 | $2,137.96 |
Cigna Setting Professional Modifier None Typical Low $12.59 Median $25.70 Typical High $46.77 | Professional | None | $12.59 | $25.70 | $46.77 |
Hometown Health Setting Professional Modifier None Typical Low $13.80 Median $24.55 Typical High $45.71 | Professional | None | $13.80 | $24.55 | $45.71 |
Hometown Health Setting Professional Modifier None Typical Low $0.24 Median $19.50 Typical High $40.74 | Professional | None | $0.24 | $19.50 | $40.74 |
Select Health Setting Facility Modifier None Typical Low $12.88 Median $27.54 Typical High $4,265.80 | Facility | None | $12.88 | $27.54 | $4,265.80 |
United Setting Facility Modifier None Typical Low $97.72 Median $245.47 Typical High $1,949.84 | Facility | None | $97.72 | $245.47 | $1,949.84 |
United Setting Professional Modifier None Typical Low $15.49 Median $27.54 Typical High $42.66 | Professional | None | $15.49 | $27.54 | $42.66 |
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 $8.51 Median $14.13 Typical High $16.22 | Professional | 52 · Reduced service | $8.51 | $14.13 | $16.22 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $3.39 Median $5.62 Typical High $6.46 | Professional | 53 · Discontinued | $3.39 | $5.62 | $6.46 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $12.88 Median $20.89 Typical High $23.99 | Professional | 54 · Surgery only | $12.88 | $20.89 | $23.99 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $2.57 Median $4.17 Typical High $4.79 | Professional | 55 · Aftercare only | $2.57 | $4.17 | $4.79 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $1.70 Median $2.82 Typical High $3.24 | Professional | 56 · Pre-op care only | $1.70 | $2.82 | $3.24 |
Where Nevada sits
The same service costs 3.5 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· 38th of 51
$30.90
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.