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 $42.66 Median $2,137.96 Typical High $10,715.19 | Facility | None | $42.66 | $2,137.96 | $10,715.19 |
Aetna Setting Professional Modifier None Typical Low $42.66 Median $69.18 Typical High $85.11 | Professional | None | $42.66 | $69.18 | $85.11 |
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 $44.67 Median $74.13 Typical High $123.03 | Professional | None | $44.67 | $74.13 | $123.03 |
Cigna Setting Facility Modifier None Typical Low $36.31 Median $41.69 Typical High $66.07 | Facility | None | $36.31 | $41.69 | $66.07 |
Cigna Setting Professional Modifier None Typical Low $39.81 Median $64.57 Typical High $107.15 | Professional | None | $39.81 | $64.57 | $107.15 |
Hometown Health Setting Professional Modifier None Typical Low $39.81 Median $63.10 Typical High $109.65 | Professional | None | $39.81 | $63.10 | $109.65 |
Hometown Health Setting Facility Modifier None Typical Low $38.02 Median $38.02 Typical High $38.02 | Facility | None | $38.02 | $38.02 | $38.02 |
Hometown Health Setting Professional Modifier None Typical Low $0.48 Median $57.54 Typical High $104.71 | Professional | None | $0.48 | $57.54 | $104.71 |
Select Health Setting Facility Modifier None Typical Low $39.81 Median $69.18 Typical High $4,265.80 | Facility | None | $39.81 | $69.18 | $4,265.80 |
Select Health Setting Professional Modifier None Typical Low $63.10 Median $63.10 Typical High $63.10 | Professional | None | $63.10 | $63.10 | $63.10 |
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 $46.77 Median $70.79 Typical High $112.20 | Professional | None | $46.77 | $70.79 | $112.20 |
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 $21.38 Median $31.62 Typical High $38.02 | Professional | 52 · Reduced service | $21.38 | $31.62 | $38.02 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $8.51 Median $12.88 Typical High $15.49 | Professional | 53 · Discontinued | $8.51 | $12.88 | $15.49 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $32.36 Median $47.86 Typical High $57.54 | Professional | 54 · Surgery only | $32.36 | $47.86 | $57.54 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $6.46 Median $9.55 Typical High $11.48 | Professional | 55 · Aftercare only | $6.46 | $9.55 | $11.48 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $4.27 Median $6.46 Typical High $7.76 | Professional | 56 · Pre-op care only | $4.27 | $6.46 | $7.76 |
Where Nevada sits
The same service costs 3.1 times more in Wisconsin than in Washington, DC. 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· 43rd of 51
$70.79
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.