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 $204.17 Median $2,238.72 Typical High $5,011.87 | Facility | None | $204.17 | $2,238.72 | $5,011.87 |
Aetna Setting Professional Modifier None Typical Low $165.96 Median $398.11 Typical High $489.78 | Professional | None | $165.96 | $398.11 | $489.78 |
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 $158.49 Median $354.81 Typical High $645.65 | Professional | None | $158.49 | $354.81 | $645.65 |
Cigna Setting Facility Modifier None Typical Low $323.59 Median $407.38 Typical High $676.08 | Facility | None | $323.59 | $407.38 | $676.08 |
Cigna Setting Professional Modifier None Typical Low $138.04 Median $269.15 Typical High $602.56 | Professional | None | $138.04 | $269.15 | $602.56 |
Hometown Health Setting Professional Modifier None Typical Low $144.54 Median $323.59 Typical High $575.44 | Professional | None | $144.54 | $323.59 | $575.44 |
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 $1.82 Median $218.78 Typical High $549.54 | Professional | None | $1.82 | $218.78 | $549.54 |
Select Health Setting Facility Modifier None Typical Low $144.54 Median $363.08 Typical High $4,265.80 | Facility | None | $144.54 | $363.08 | $4,265.80 |
Select Health Setting Professional Modifier None Typical Low $323.59 Median $323.59 Typical High $323.59 | Professional | None | $323.59 | $323.59 | $323.59 |
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 $154.88 Median $338.84 Typical High $588.84 | Professional | None | $154.88 | $338.84 | $588.84 |
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 $83.18 Median $147.91 Typical High $245.47 | Professional | 52 · Reduced service | $83.18 | $147.91 | $245.47 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $33.11 Median $60.26 Typical High $97.72 | Professional | 53 · Discontinued | $33.11 | $60.26 | $97.72 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $125.89 Median $223.87 Typical High $371.54 | Professional | 54 · Surgery only | $125.89 | $223.87 | $371.54 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $25.12 Median $44.67 Typical High $74.13 | Professional | 55 · Aftercare only | $25.12 | $44.67 | $74.13 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $16.60 Median $29.51 Typical High $48.98 | Professional | 56 · Pre-op care only | $16.60 | $29.51 | $48.98 |
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· 32nd of 51
$389
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.