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 $93.33 Median $1,698.24 Typical High $4,365.16 | Facility | None | $93.33 | $1,698.24 | $4,365.16 |
Aetna Setting Professional Modifier None Typical Low $83.18 Median $120.23 Typical High $154.88 | Professional | None | $83.18 | $120.23 | $154.88 |
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 $87.10 Median $131.83 Typical High $218.78 | Professional | None | $87.10 | $131.83 | $218.78 |
Cigna Setting Facility Modifier None Typical Low $79.43 Median $100.00 Typical High $549.54 | Facility | None | $79.43 | $100.00 | $549.54 |
Cigna Setting Professional Modifier None Typical Low $75.86 Median $97.72 Typical High $177.83 | Professional | None | $75.86 | $97.72 | $177.83 |
Hometown Health Setting Professional Modifier None Typical Low $79.43 Median $120.23 Typical High $208.93 | Professional | None | $79.43 | $120.23 | $208.93 |
Hometown Health Setting Facility Modifier None Typical Low $79.43 Median $79.43 Typical High $79.43 | Facility | None | $79.43 | $79.43 | $79.43 |
Hometown Health Setting Professional Modifier None Typical Low $1.38 Median $117.49 Typical High $204.17 | Professional | None | $1.38 | $117.49 | $204.17 |
Select Health Setting Facility Modifier None Typical Low $79.43 Median $134.90 Typical High $4,265.80 | Facility | None | $79.43 | $134.90 | $4,265.80 |
Select Health Setting Professional Modifier None Typical Low $123.03 Median $123.03 Typical High $123.03 | Professional | None | $123.03 | $123.03 | $123.03 |
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 $91.20 Median $128.82 Typical High $186.21 | Professional | None | $91.20 | $128.82 | $186.21 |
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 $41.69 Median $57.54 Typical High $69.18 | Professional | 52 · Reduced service | $41.69 | $57.54 | $69.18 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $16.98 Median $22.91 Typical High $27.54 | Professional | 53 · Discontinued | $16.98 | $22.91 | $27.54 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $63.10 Median $87.10 Typical High $102.33 | Professional | 54 · Surgery only | $63.10 | $87.10 | $102.33 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $12.59 Median $17.38 Typical High $20.42 | Professional | 55 · Aftercare only | $12.59 | $17.38 | $20.42 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $8.32 Median $11.48 Typical High $13.80 | Professional | 56 · Pre-op care only | $8.32 | $11.48 | $13.80 |
Where Nevada sits
The same service costs 3.3 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
$129
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.