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 $79.43 Median $1,698.24 Typical High $4,365.16 | Facility | None | $79.43 | $1,698.24 | $4,365.16 |
Aetna Setting Professional Modifier None Typical Low $31.62 Median $79.43 Typical High $100.00 | Professional | None | $31.62 | $79.43 | $100.00 |
Ambetter Setting Professional Modifier None Typical Low $63.10 Median $63.10 Typical High $151.36 | Professional | None | $63.10 | $63.10 | $151.36 |
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 $30.20 Median $75.86 Typical High $125.89 | Professional | None | $30.20 | $75.86 | $125.89 |
Cigna Setting Facility Modifier None Typical Low $56.23 Median $64.57 Typical High $100.00 | Facility | None | $56.23 | $64.57 | $100.00 |
Cigna Setting Professional Modifier None Typical Low $36.31 Median $70.79 Typical High $117.49 | Professional | None | $36.31 | $70.79 | $117.49 |
Hometown Health Setting Professional Modifier None Typical Low $30.90 Median $67.61 Typical High $123.03 | Professional | None | $30.90 | $67.61 | $123.03 |
Hometown Health Setting Facility Modifier None Typical Low $58.88 Median $58.88 Typical High $58.88 | Facility | None | $58.88 | $58.88 | $58.88 |
Hometown Health Setting Professional Modifier None Typical Low $0.18 Median $38.90 Typical High $117.49 | Professional | None | $0.18 | $38.90 | $117.49 |
Select Health Setting Facility Modifier None Typical Low $25.70 Median $77.62 Typical High $4,265.80 | Facility | None | $25.70 | $77.62 | $4,265.80 |
Select Health Setting Professional Modifier None Typical Low $70.79 Median $70.79 Typical High $70.79 | Professional | None | $70.79 | $70.79 | $70.79 |
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 $28.84 Median $74.13 Typical High $123.03 | Professional | None | $28.84 | $74.13 | $123.03 |
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 $15.85 Median $32.36 Typical High $48.98 | Professional | 52 · Reduced service | $15.85 | $32.36 | $48.98 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $6.31 Median $12.88 Typical High $19.50 | Professional | 53 · Discontinued | $6.31 | $12.88 | $19.50 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $23.99 Median $48.98 Typical High $72.44 | Professional | 54 · Surgery only | $23.99 | $48.98 | $72.44 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $4.79 Median $9.77 Typical High $14.45 | Professional | 55 · Aftercare only | $4.79 | $9.77 | $14.45 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $3.16 Median $6.46 Typical High $9.77 | Professional | 56 · Pre-op care only | $3.16 | $6.46 | $9.77 |
Where Nevada sits
The same service costs 3.1 times more in Wisconsin than in Nebraska. 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· 46th of 51
$75.86
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.