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 $64.57 Median $1,698.24 Typical High $4,365.16 | Facility | None | $64.57 | $1,698.24 | $4,365.16 |
Aetna Setting Professional Modifier None Typical Low $52.48 Median $100.00 Typical High $131.83 | Professional | None | $52.48 | $100.00 | $131.83 |
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 $50.12 Median $95.50 Typical High $158.49 | Professional | None | $50.12 | $95.50 | $158.49 |
Cigna Setting Facility Modifier None Typical Low $70.79 Median $89.13 Typical High $549.54 | Facility | None | $70.79 | $89.13 | $549.54 |
Cigna Setting Professional Modifier None Typical Low $42.66 Median $74.13 Typical High $151.36 | Professional | None | $42.66 | $74.13 | $151.36 |
Hometown Health Setting Professional Modifier None Typical Low $46.77 Median $81.28 Typical High $158.49 | Professional | None | $46.77 | $81.28 | $158.49 |
Hometown Health Setting Facility Modifier None Typical Low $70.79 Median $70.79 Typical High $70.79 | Facility | None | $70.79 | $70.79 | $70.79 |
Hometown Health Setting Professional Modifier None Typical Low $0.42 Median $69.18 Typical High $151.36 | Professional | None | $0.42 | $69.18 | $151.36 |
Select Health Setting Facility Modifier None Typical Low $46.77 Median $100.00 Typical High $4,265.80 | Facility | None | $46.77 | $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 $50.12 Median $95.50 Typical High $158.49 | Professional | None | $50.12 | $95.50 | $158.49 |
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 $26.30 Median $45.71 Typical High $61.66 | Professional | 52 · Reduced service | $26.30 | $45.71 | $61.66 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $10.47 Median $18.20 Typical High $24.55 | Professional | 53 · Discontinued | $10.47 | $18.20 | $24.55 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $38.90 Median $69.18 Typical High $91.20 | Professional | 54 · Surgery only | $38.90 | $69.18 | $91.20 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $7.76 Median $13.80 Typical High $18.20 | Professional | 55 · Aftercare only | $7.76 | $13.80 | $18.20 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $5.25 Median $9.12 Typical High $12.30 | Professional | 56 · Pre-op care only | $5.25 | $9.12 | $12.30 |
Where Nevada sits
The same service costs 2.8 times more in Wisconsin than in Kentucky. 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· 41st of 51
$97.72
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.