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 $87.10 Median $2,137.96 Typical High $10,715.19 | Facility | None | $87.10 | $2,137.96 | $10,715.19 |
Aetna Setting Professional Modifier None Typical Low $87.10 Median $123.03 Typical High $131.83 | Professional | None | $87.10 | $123.03 | $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 $83.18 Median $125.89 Typical High $199.53 | Professional | None | $83.18 | $125.89 | $199.53 |
Cigna Setting Facility Modifier None Typical Low $74.13 Median $85.11 Typical High $131.83 | Facility | None | $74.13 | $85.11 | $131.83 |
Cigna Setting Professional Modifier None Typical Low $70.79 Median $100.00 Typical High $177.83 | Professional | None | $70.79 | $100.00 | $177.83 |
Hometown Health Setting Professional Modifier None Typical Low $74.13 Median $114.82 Typical High $199.53 | Professional | None | $74.13 | $114.82 | $199.53 |
Hometown Health Setting Facility Modifier None Typical Low $77.62 Median $77.62 Typical High $77.62 | Facility | None | $77.62 | $77.62 | $77.62 |
Hometown Health Setting Professional Modifier None Typical Low $0.18 Median $114.82 Typical High $186.21 | Professional | None | $0.18 | $114.82 | $186.21 |
Select Health Setting Facility Modifier None Typical Low $75.86 Median $125.89 Typical High $4,265.80 | Facility | None | $75.86 | $125.89 | $4,265.80 |
Select Health Setting Professional Modifier None Typical Low $112.20 Median $112.20 Typical High $112.20 | Professional | None | $112.20 | $112.20 | $112.20 |
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 $77.62 Median $120.23 Typical High $181.97 | Professional | None | $77.62 | $120.23 | $181.97 |
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 $43.65 Median $61.66 Typical High $63.10 | Professional | 52 · Reduced service | $43.65 | $61.66 | $63.10 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $17.78 Median $24.55 Typical High $25.12 | Professional | 53 · Discontinued | $17.78 | $24.55 | $25.12 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $66.07 Median $91.20 Typical High $95.50 | Professional | 54 · Surgery only | $66.07 | $91.20 | $95.50 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $13.18 Median $18.20 Typical High $19.05 | Professional | 55 · Aftercare only | $13.18 | $18.20 | $19.05 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $8.71 Median $12.30 Typical High $12.59 | Professional | 56 · Pre-op care only | $8.71 | $12.30 | $12.59 |
Where Nevada sits
The same service costs 3.2 times more in Wisconsin than in Texas. 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· 37th of 51
$126
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.