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 $63.10 Median $1,698.24 Typical High $4,365.16 | Facility | None | $63.10 | $1,698.24 | $4,365.16 |
Aetna Setting Professional Modifier None Typical Low $63.10 Median $138.04 Typical High $165.96 | Professional | None | $63.10 | $138.04 | $165.96 |
Anthem BCBS Setting Professional Modifier None Typical Low $60.26 Median $134.90 Typical High $263.03 | Professional | None | $60.26 | $134.90 | $263.03 |
Cigna Setting Professional Modifier None Typical Low $51.29 Median $114.82 Typical High $302.00 | Professional | None | $51.29 | $114.82 | $302.00 |
Hometown Health Setting Professional Modifier None Typical Low $51.29 Median $102.33 Typical High $218.78 | Professional | None | $51.29 | $102.33 | $218.78 |
Hometown Health Setting Professional Modifier None Typical Low $0.42 Median $77.62 Typical High $218.78 | Professional | None | $0.42 | $77.62 | $218.78 |
Select Health Setting Facility Modifier None Typical Low $51.29 Median $147.91 Typical High $4,265.80 | Facility | None | $51.29 | $147.91 | $4,265.80 |
Select Health Setting Professional Modifier None Typical Low $38.90 Median $38.90 Typical High $51.29 | Professional | None | $38.90 | $38.90 | $51.29 |
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 $50.12 Median $147.91 Typical High $245.47 | Professional | None | $50.12 | $147.91 | $245.47 |
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 $31.62 Median $64.57 Typical High $83.18 | Professional | 52 · Reduced service | $31.62 | $64.57 | $83.18 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $12.88 Median $25.70 Typical High $33.11 | Professional | 53 · Discontinued | $12.88 | $25.70 | $33.11 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $47.86 Median $95.50 Typical High $125.89 | Professional | 54 · Surgery only | $47.86 | $95.50 | $125.89 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $9.55 Median $19.05 Typical High $25.12 | Professional | 55 · Aftercare only | $9.55 | $19.05 | $25.12 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $6.31 Median $12.88 Typical High $16.60 | Professional | 56 · Pre-op care only | $6.31 | $12.88 | $16.60 |
Where Nevada sits
The same service costs 3.7 times more in Wisconsin than in Maryland. 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
$135
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.