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 $66.07 Median $1,698.24 Typical High $4,365.16 | Facility | None | $66.07 | $1,698.24 | $4,365.16 |
Aetna Setting Professional Modifier None Typical Low $60.26 Median $97.72 Typical High $120.23 | Professional | None | $60.26 | $97.72 | $120.23 |
Ambetter Setting Professional Modifier None Typical Low $89.13 Median $89.13 Typical High $97.72 | Professional | None | $89.13 | $89.13 | $97.72 |
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 $63.10 Median $102.33 Typical High $186.21 | Professional | None | $63.10 | $102.33 | $186.21 |
Cigna Setting Facility Modifier None Typical Low $51.29 Median $60.26 Typical High $93.33 | Facility | None | $51.29 | $60.26 | $93.33 |
Cigna Setting Professional Modifier None Typical Low $74.13 Median $93.33 Typical High $147.91 | Professional | None | $74.13 | $93.33 | $147.91 |
Hometown Health Setting Professional Modifier None Typical Low $63.10 Median $93.33 Typical High $154.88 | Professional | None | $63.10 | $93.33 | $154.88 |
Hometown Health Setting Facility Modifier None Typical Low $54.95 Median $54.95 Typical High $54.95 | Facility | None | $54.95 | $54.95 | $54.95 |
Hometown Health Setting Professional Modifier None Typical Low $0.60 Median $81.28 Typical High $144.54 | Professional | None | $0.60 | $81.28 | $144.54 |
Select Health Setting Facility Modifier None Typical Low $53.70 Median $97.72 Typical High $4,265.80 | Facility | None | $53.70 | $97.72 | $4,265.80 |
Select Health Setting Professional Modifier None Typical Low $87.10 Median $87.10 Typical High $87.10 | Professional | None | $87.10 | $87.10 | $87.10 |
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 $64.57 Median $100.00 Typical High $151.36 | Professional | None | $64.57 | $100.00 | $151.36 |
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 $30.20 Median $43.65 Typical High $53.70 | Professional | 52 · Reduced service | $30.20 | $43.65 | $53.70 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $12.02 Median $17.38 Typical High $21.38 | Professional | 53 · Discontinued | $12.02 | $17.38 | $21.38 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $45.71 Median $66.07 Typical High $79.43 | Professional | 54 · Surgery only | $45.71 | $66.07 | $79.43 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $9.12 Median $13.18 Typical High $15.85 | Professional | 55 · Aftercare only | $9.12 | $13.18 | $15.85 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $6.03 Median $8.71 Typical High $10.72 | Professional | 56 · Pre-op care only | $6.03 | $8.71 | $10.72 |
Where Nevada sits
The same service costs 3.0 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· 46th 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.