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 $38.90 Median $1,698.24 Typical High $4,365.16 | Facility | None | $38.90 | $1,698.24 | $4,365.16 |
Aetna Setting Professional Modifier None Typical Low $38.90 Median $138.04 Typical High $194.98 | Professional | None | $38.90 | $138.04 | $194.98 |
Anthem BCBS Setting Professional Modifier None Typical Low $36.31 Median $128.82 Typical High $309.03 | Professional | None | $36.31 | $128.82 | $309.03 |
Cigna Setting Professional Modifier None Typical Low $32.36 Median $67.61 Typical High $257.04 | Professional | None | $32.36 | $67.61 | $257.04 |
Hometown Health Setting Professional Modifier None Typical Low $31.62 Median $63.10 Typical High $257.04 | Professional | None | $31.62 | $63.10 | $257.04 |
Hometown Health Setting Professional Modifier None Typical Low $1.20 Median $47.86 Typical High $257.04 | Professional | None | $1.20 | $47.86 | $257.04 |
Select Health Setting Facility Modifier None Typical Low $31.62 Median $169.82 Typical High $4,265.80 | Facility | None | $31.62 | $169.82 | $4,265.80 |
Select Health Setting Professional Modifier None Typical Low $23.99 Median $23.99 Typical High $31.62 | Professional | None | $23.99 | $23.99 | $31.62 |
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 $38.90 Median $134.90 Typical High $251.19 | Professional | None | $38.90 | $134.90 | $251.19 |
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 $19.50 Median $56.23 Typical High $97.72 | Professional | 52 · Reduced service | $19.50 | $56.23 | $97.72 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $7.76 Median $22.39 Typical High $39.81 | Professional | 53 · Discontinued | $7.76 | $22.39 | $39.81 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $29.51 Median $83.18 Typical High $147.91 | Professional | 54 · Surgery only | $29.51 | $83.18 | $147.91 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $5.89 Median $16.60 Typical High $29.51 | Professional | 55 · Aftercare only | $5.89 | $16.60 | $29.51 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $3.89 Median $11.22 Typical High $19.50 | Professional | 56 · Pre-op care only | $3.89 | $11.22 | $19.50 |
Where Nevada sits
The same service costs 4.5 times more in Wisconsin than in Michigan. 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· 37th of 51
$126
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.