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 $52.48 Median $1,698.24 Typical High $4,365.16 | Facility | None | $52.48 | $1,698.24 | $4,365.16 |
Aetna Setting Professional Modifier None Typical Low $42.66 Median $77.62 Typical High $95.50 | Professional | None | $42.66 | $77.62 | $95.50 |
Ambetter Setting Professional Modifier None Typical Low $74.13 Median $74.13 Typical High $74.13 | Professional | None | $74.13 | $74.13 | $74.13 |
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 $40.74 Median $74.13 Typical High $123.03 | Professional | None | $40.74 | $74.13 | $123.03 |
Cigna Setting Facility Modifier None Typical Low $52.48 Median $61.66 Typical High $95.50 | Facility | None | $52.48 | $61.66 | $95.50 |
Cigna Setting Professional Modifier None Typical Low $34.67 Median $60.26 Typical High $109.65 | Professional | None | $34.67 | $60.26 | $109.65 |
Hometown Health Setting Professional Modifier None Typical Low $37.15 Median $64.57 Typical High $123.03 | Professional | None | $37.15 | $64.57 | $123.03 |
Hometown Health Setting Facility Modifier None Typical Low $56.23 Median $56.23 Typical High $56.23 | Facility | None | $56.23 | $56.23 | $56.23 |
Hometown Health Setting Professional Modifier None Typical Low $0.30 Median $54.95 Typical High $117.49 | Professional | None | $0.30 | $54.95 | $117.49 |
Select Health Setting Facility Modifier None Typical Low $37.15 Median $77.62 Typical High $4,265.80 | Facility | None | $37.15 | $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 $38.90 Median $70.79 Typical High $114.82 | Professional | None | $38.90 | $70.79 | $114.82 |
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 $20.89 Median $35.48 Typical High $47.86 | Professional | 52 · Reduced service | $20.89 | $35.48 | $47.86 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $8.51 Median $14.13 Typical High $19.05 | Professional | 53 · Discontinued | $8.51 | $14.13 | $19.05 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $31.62 Median $53.70 Typical High $70.79 | Professional | 54 · Surgery only | $31.62 | $53.70 | $70.79 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $6.31 Median $10.72 Typical High $14.13 | Professional | 55 · Aftercare only | $6.31 | $10.72 | $14.13 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $4.27 Median $7.08 Typical High $9.55 | Professional | 56 · Pre-op care only | $4.27 | $7.08 | $9.55 |
Where Nevada sits
The same service costs 3.2 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· 42nd of 51
$74.13
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.