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 $100.00 Median $1,698.24 Typical High $4,365.16 | Facility | None | $100.00 | $1,698.24 | $4,365.16 |
Aetna Setting Professional Modifier None Typical Low $81.28 Median $141.25 Typical High $173.78 | Professional | None | $81.28 | $141.25 | $173.78 |
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 $77.62 Median $134.90 Typical High $223.87 | Professional | None | $77.62 | $134.90 | $223.87 |
Cigna Setting Facility Modifier None Typical Low $309.03 Median $363.08 Typical High $549.54 | Facility | None | $309.03 | $363.08 | $549.54 |
Cigna Setting Professional Modifier None Typical Low $64.57 Median $83.18 Typical High $213.80 | Professional | None | $64.57 | $83.18 | $213.80 |
Hometown Health Setting Professional Modifier None Typical Low $72.44 Median $114.82 Typical High $389.05 | Professional | None | $72.44 | $114.82 | $389.05 |
Hometown Health Setting Facility Modifier None Typical Low $323.59 Median $323.59 Typical High $323.59 | Facility | None | $323.59 | $323.59 | $323.59 |
Hometown Health Setting Professional Modifier None Typical Low $2.00 Median $107.15 Typical High $489.78 | Professional | None | $2.00 | $107.15 | $489.78 |
Select Health Setting Facility Modifier None Typical Low $72.44 Median $141.25 Typical High $4,265.80 | Facility | None | $72.44 | $141.25 | $4,265.80 |
Select Health Setting Professional Modifier None Typical Low $125.89 Median $125.89 Typical High $125.89 | Professional | None | $125.89 | $125.89 | $125.89 |
United Setting Facility Modifier None Typical Low $302.00 Median $512.86 Typical High $2,137.96 | Facility | None | $302.00 | $512.86 | $2,137.96 |
United Setting Professional Modifier None Typical Low $79.43 Median $131.83 Typical High $218.78 | Professional | None | $79.43 | $131.83 | $218.78 |
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 $40.74 Median $63.10 Typical High $87.10 | Professional | 52 · Reduced service | $40.74 | $63.10 | $87.10 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $16.22 Median $25.70 Typical High $34.67 | Professional | 53 · Discontinued | $16.22 | $25.70 | $34.67 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $60.26 Median $95.50 Typical High $128.82 | Professional | 54 · Surgery only | $60.26 | $95.50 | $128.82 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $12.02 Median $19.05 Typical High $25.70 | Professional | 55 · Aftercare only | $12.02 | $19.05 | $25.70 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $8.13 Median $12.59 Typical High $17.38 | Professional | 56 · Pre-op care only | $8.13 | $12.59 | $17.38 |
Where Nevada sits
The same service costs 3.6 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· 46th of 51
$141
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.