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 $77.62 Median $1,698.24 Typical High $4,365.16 | Facility | None | $77.62 | $1,698.24 | $4,365.16 |
Aetna Setting Professional Modifier None Typical Low $77.62 Median $177.83 Typical High $204.17 | Professional | None | $77.62 | $177.83 | $204.17 |
Ambetter Setting Professional Modifier None Typical Low $60.26 Median $60.26 Typical High $60.26 | Professional | None | $60.26 | $60.26 | $60.26 |
Anthem BCBS Setting Professional Modifier None Typical Low $67.61 Median $162.18 Typical High $302.00 | Professional | None | $67.61 | $162.18 | $302.00 |
Cigna Setting Professional Modifier None Typical Low $61.66 Median $177.83 Typical High $281.84 | Professional | None | $61.66 | $177.83 | $281.84 |
Hometown Health Setting Professional Modifier None Typical Low $67.61 Median $173.78 Typical High $269.15 | Professional | None | $67.61 | $173.78 | $269.15 |
Hometown Health Setting Professional Modifier None Typical Low $0.89 Median $91.20 Typical High $251.19 | Professional | None | $0.89 | $91.20 | $251.19 |
Select Health Setting Facility Modifier None Typical Low $60.26 Median $169.82 Typical High $4,265.80 | Facility | None | $60.26 | $169.82 | $4,265.80 |
Select Health Setting Professional Modifier None Typical Low $51.29 Median $104.71 Typical High $169.82 | Professional | None | $51.29 | $104.71 | $169.82 |
United Setting Facility Modifier None Typical Low $251.19 Median $1,412.54 Typical High $2,041.74 | Facility | None | $251.19 | $1,412.54 | $2,041.74 |
United Setting Professional Modifier None Typical Low $77.62 Median $186.21 Typical High $302.00 | Professional | None | $77.62 | $186.21 | $302.00 |
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 $38.90 Median $61.66 Typical High $93.33 | Professional | 52 · Reduced service | $38.90 | $61.66 | $93.33 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $15.49 Median $24.55 Typical High $37.15 | Professional | 53 · Discontinued | $15.49 | $24.55 | $37.15 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $57.54 Median $91.20 Typical High $141.25 | Professional | 54 · Surgery only | $57.54 | $91.20 | $141.25 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $11.48 Median $18.20 Typical High $28.18 | Professional | 55 · Aftercare only | $11.48 | $18.20 | $28.18 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $7.76 Median $12.30 Typical High $18.62 | Professional | 56 · Pre-op care only | $7.76 | $12.30 | $18.62 |
Where Nevada sits
The same service costs 2.7 times more in Wisconsin than in Utah. 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
$174
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.