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 $64.57 Median $91.20 Typical High $112.20 | Professional | None | $64.57 | $91.20 | $112.20 |
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 $61.66 Median $91.20 Typical High $144.54 | Professional | None | $61.66 | $91.20 | $144.54 |
Cigna Setting Facility Modifier None Typical Low $48.98 Median $61.66 Typical High $549.54 | Facility | None | $48.98 | $61.66 | $549.54 |
Cigna Setting Professional Modifier None Typical Low $52.48 Median $70.79 Typical High $131.83 | Professional | None | $52.48 | $70.79 | $131.83 |
Hometown Health Setting Professional Modifier None Typical Low $50.12 Median $77.62 Typical High $141.25 | Professional | None | $50.12 | $77.62 | $141.25 |
Hometown Health Setting Facility Modifier None Typical Low $48.98 Median $48.98 Typical High $48.98 | Facility | None | $48.98 | $48.98 | $48.98 |
Hometown Health Setting Professional Modifier None Typical Low $0.30 Median $74.13 Typical High $134.90 | Professional | None | $0.30 | $74.13 | $134.90 |
Select Health Setting Facility Modifier None Typical Low $54.95 Median $91.20 Typical High $4,265.80 | Facility | None | $54.95 | $91.20 | $4,265.80 |
Select Health Setting Professional Modifier None Typical Low $81.28 Median $81.28 Typical High $81.28 | Professional | None | $81.28 | $81.28 | $81.28 |
United Setting Facility Modifier None Typical Low $97.72 Median $234.42 Typical High $1,949.84 | Facility | None | $97.72 | $234.42 | $1,949.84 |
United Setting Professional Modifier None Typical Low $58.88 Median $87.10 Typical High $134.90 | Professional | None | $58.88 | $87.10 | $134.90 |
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 $32.36 Median $41.69 Typical High $56.23 | Professional | 52 · Reduced service | $32.36 | $41.69 | $56.23 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $12.88 Median $16.60 Typical High $22.39 | Professional | 53 · Discontinued | $12.88 | $16.60 | $22.39 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $47.86 Median $63.10 Typical High $83.18 | Professional | 54 · Surgery only | $47.86 | $63.10 | $83.18 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $9.55 Median $12.59 Typical High $16.60 | Professional | 55 · Aftercare only | $9.55 | $12.59 | $16.60 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $6.46 Median $8.32 Typical High $11.22 | Professional | 56 · Pre-op care only | $6.46 | $8.32 | $11.22 |
Where Nevada sits
The same service costs 3.5 times more in Wisconsin than in Florida. 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· 40th of 51
$91.20
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.