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 $758.58 Median $1,698.24 Typical High $4,365.16 | Facility | None | $758.58 | $1,698.24 | $4,365.16 |
Aetna Setting Professional Modifier None Typical Low $181.97 Median $524.81 Typical High $794.33 | Professional | None | $181.97 | $524.81 | $794.33 |
Ambetter Setting Professional Modifier None Typical Low $128.82 Median $144.54 Typical High $616.60 | Professional | None | $128.82 | $144.54 | $616.60 |
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 $162.18 Median $602.56 Typical High $1,202.26 | Professional | None | $162.18 | $602.56 | $1,202.26 |
Cigna Setting Facility Modifier None Typical Low $562.34 Median $660.69 Typical High $1,122.02 | Facility | None | $562.34 | $660.69 | $1,122.02 |
Cigna Setting Professional Modifier None Typical Low $120.23 Median $467.74 Typical High $977.24 | Professional | None | $120.23 | $467.74 | $977.24 |
Hometown Health Setting Professional Modifier None Typical Low $128.82 Median $478.63 Typical High $1,023.29 | Professional | None | $128.82 | $478.63 | $1,023.29 |
Hometown Health Setting Facility Modifier None Typical Low $588.84 Median $588.84 Typical High $588.84 | Facility | None | $588.84 | $588.84 | $588.84 |
Hometown Health Setting Professional Modifier None Typical Low $1.32 Median $218.78 Typical High $1,023.29 | Professional | None | $1.32 | $218.78 | $1,023.29 |
Select Health Setting Facility Modifier None Typical Low $144.54 Median $691.83 Typical High $4,265.80 | Facility | None | $144.54 | $691.83 | $4,265.80 |
Select Health Setting Professional Modifier None Typical Low $109.65 Median $109.65 Typical High $144.54 | Professional | None | $109.65 | $109.65 | $144.54 |
United Setting Facility Modifier None Typical Low $467.74 Median $776.25 Typical High $2,884.03 | Facility | None | $467.74 | $776.25 | $2,884.03 |
United Setting Professional Modifier None Typical Low $169.82 Median $602.56 Typical High $1,023.29 | Professional | None | $169.82 | $602.56 | $1,023.29 |
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 $91.20 Median $257.04 Typical High $398.11 | Professional | 52 · Reduced service | $91.20 | $257.04 | $398.11 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $36.31 Median $102.33 Typical High $158.49 | Professional | 53 · Discontinued | $36.31 | $102.33 | $158.49 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $138.04 Median $380.19 Typical High $602.56 | Professional | 54 · Surgery only | $138.04 | $380.19 | $602.56 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $27.54 Median $75.86 Typical High $120.23 | Professional | 55 · Aftercare only | $27.54 | $75.86 | $120.23 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $18.20 Median $51.29 Typical High $79.43 | Professional | 56 · Pre-op care only | $18.20 | $51.29 | $79.43 |
Where Nevada sits
The same service costs 5.2 times more in Wisconsin than in Hawaii. 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· 33rd of 51
$603
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.