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 $54.95 Median $2,137.96 Typical High $10,715.19 | Facility | None | $54.95 | $2,137.96 | $10,715.19 |
Aetna Setting Professional Modifier None Typical Low $54.95 Median $77.62 Typical High $95.50 | Professional | None | $54.95 | $77.62 | $95.50 |
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 $57.54 Median $91.20 Typical High $151.36 | Professional | None | $57.54 | $91.20 | $151.36 |
Cigna Setting Facility Modifier None Typical Low $53.70 Median $66.07 Typical High $549.54 | Facility | None | $53.70 | $66.07 | $549.54 |
Cigna Setting Professional Modifier None Typical Low $48.98 Median $72.44 Typical High $128.82 | Professional | None | $48.98 | $72.44 | $128.82 |
Hometown Health Setting Professional Modifier None Typical Low $52.48 Median $79.43 Typical High $141.25 | Professional | None | $52.48 | $79.43 | $141.25 |
Hometown Health Setting Facility Modifier None Typical Low $53.70 Median $53.70 Typical High $53.70 | Facility | None | $53.70 | $53.70 | $53.70 |
Hometown Health Setting Professional Modifier None Typical Low $0.83 Median $72.44 Typical High $138.04 | Professional | None | $0.83 | $72.44 | $138.04 |
Select Health Setting Facility Modifier None Typical Low $48.98 Median $91.20 Typical High $4,265.80 | Facility | None | $48.98 | $91.20 | $4,265.80 |
Select Health Setting Professional Modifier None Typical Low $83.18 Median $83.18 Typical High $83.18 | Professional | None | $83.18 | $83.18 | $83.18 |
United Setting Facility Modifier None Typical Low $97.72 Median $234.42 Typical High $1,949.84 | Facility | None | $97.72 | $234.42 | $1,949.84 |
United Setting Professional Modifier None Typical Low $58.88 Median $89.13 Typical High $134.90 | Professional | None | $58.88 | $89.13 | $134.90 |
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 $27.54 Median $38.90 Typical High $47.86 | Professional | 52 · Reduced service | $27.54 | $38.90 | $47.86 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $10.96 Median $15.85 Typical High $19.05 | Professional | 53 · Discontinued | $10.96 | $15.85 | $19.05 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $40.74 Median $58.88 Typical High $70.79 | Professional | 54 · Surgery only | $40.74 | $58.88 | $70.79 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $8.32 Median $11.75 Typical High $14.13 | Professional | 55 · Aftercare only | $8.32 | $11.75 | $14.13 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $5.50 Median $7.76 Typical High $9.55 | Professional | 56 · Pre-op care only | $5.50 | $7.76 | $9.55 |
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· 44th of 51
$89.13
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.