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 $29.51 Median $1,698.24 Typical High $4,365.16 | Facility | None | $29.51 | $1,698.24 | $4,365.16 |
Aetna Setting Professional Modifier None Typical Low $29.51 Median $97.72 Typical High $123.03 | Professional | None | $29.51 | $97.72 | $123.03 |
Anthem BCBS Setting Facility Modifier None Typical Low $2,238.72 Median $3,548.13 Typical High $4,466.84 | Facility | None | $2,238.72 | $3,548.13 | $4,466.84 |
Anthem BCBS Setting Professional Modifier None Typical Low $27.54 Median $85.11 Typical High $165.96 | Professional | None | $27.54 | $85.11 | $165.96 |
Cigna Setting Facility Modifier None Typical Low $89.13 Median $102.33 Typical High $162.18 | Facility | None | $89.13 | $102.33 | $162.18 |
Cigna Setting Professional Modifier None Typical Low $32.36 Median $63.10 Typical High $144.54 | Professional | None | $32.36 | $63.10 | $144.54 |
Hometown Health Setting Professional Modifier None Typical Low $28.84 Median $100.00 Typical High $162.18 | Professional | None | $28.84 | $100.00 | $162.18 |
Hometown Health Setting Facility Modifier None Typical Low $93.33 Median $93.33 Typical High $93.33 | Facility | None | $93.33 | $93.33 | $93.33 |
Hometown Health Setting Professional Modifier None Typical Low $0.89 Median $42.66 Typical High $151.36 | Professional | None | $0.89 | $42.66 | $151.36 |
Select Health Setting Facility Modifier None Typical Low $28.18 Median $100.00 Typical High $4,265.80 | Facility | None | $28.18 | $100.00 | $4,265.80 |
Select Health Setting Professional Modifier None Typical Low $91.20 Median $91.20 Typical High $91.20 | Professional | None | $91.20 | $91.20 | $91.20 |
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 $30.20 Median $85.11 Typical High $141.25 | Professional | None | $30.20 | $85.11 | $141.25 |
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 $14.79 Median $25.12 Typical High $51.29 | Professional | 52 · Reduced service | $14.79 | $25.12 | $51.29 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $5.89 Median $10.00 Typical High $20.89 | Professional | 53 · Discontinued | $5.89 | $10.00 | $20.89 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $21.88 Median $37.15 Typical High $77.62 | Professional | 54 · Surgery only | $21.88 | $37.15 | $77.62 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $4.37 Median $7.59 Typical High $15.49 | Professional | 55 · Aftercare only | $4.37 | $7.59 | $15.49 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $2.95 Median $5.01 Typical High $10.47 | Professional | 56 · Pre-op care only | $2.95 | $5.01 | $10.47 |
Where Nevada sits
The same service costs 5.4 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· 31st of 51
$100
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.