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 $67.61 Median $1,698.24 Typical High $4,365.16 | Facility | None | $67.61 | $1,698.24 | $4,365.16 |
Aetna Setting Professional Modifier None Typical Low $61.66 Median $91.20 Typical High $114.82 | Professional | None | $61.66 | $91.20 | $114.82 |
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 $64.57 Median $102.33 Typical High $173.78 | Professional | None | $64.57 | $102.33 | $173.78 |
Cigna Setting Facility Modifier None Typical Low $61.66 Median $77.62 Typical High $549.54 | Facility | None | $61.66 | $77.62 | $549.54 |
Cigna Setting Professional Modifier None Typical Low $54.95 Median $74.13 Typical High $141.25 | Professional | None | $54.95 | $74.13 | $141.25 |
Hometown Health Setting Professional Modifier None Typical Low $58.88 Median $89.13 Typical High $154.88 | Professional | None | $58.88 | $89.13 | $154.88 |
Hometown Health Setting Facility Modifier None Typical Low $61.66 Median $61.66 Typical High $61.66 | Facility | None | $61.66 | $61.66 | $61.66 |
Hometown Health Setting Professional Modifier None Typical Low $0.48 Median $85.11 Typical High $154.88 | Professional | None | $0.48 | $85.11 | $154.88 |
Select Health Setting Facility Modifier None Typical Low $57.54 Median $104.71 Typical High $4,265.80 | Facility | None | $57.54 | $104.71 | $4,265.80 |
Select Health Setting Professional Modifier None Typical Low $93.33 Median $93.33 Typical High $93.33 | Professional | None | $93.33 | $93.33 | $93.33 |
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 $64.57 Median $97.72 Typical High $144.54 | Professional | None | $64.57 | $97.72 | $144.54 |
6 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 $30.90 Median $44.67 Typical High $53.70 | Professional | 52 · Reduced service | $30.90 | $44.67 | $53.70 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $12.30 Median $17.78 Typical High $21.38 | Professional | 53 · Discontinued | $12.30 | $17.78 | $21.38 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $46.77 Median $66.07 Typical High $81.28 | Professional | 54 · Surgery only | $46.77 | $66.07 | $81.28 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $9.33 Median $13.18 Typical High $16.22 | Professional | 55 · Aftercare only | $9.33 | $13.18 | $16.22 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $6.17 Median $8.91 Typical High $10.72 | Professional | 56 · Pre-op care only | $6.17 | $8.91 | $10.72 |
Ambetter Setting Professional Modifier 51 · Multiple procedures Typical Low $128.82 Median $128.82 Typical High $128.82 | Professional | 51 · Multiple procedures | $128.82 | $128.82 | $128.82 |
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· 40th of 51
$100
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.