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 $53.70 Median $1,698.24 Typical High $4,365.16 | Facility | None | $53.70 | $1,698.24 | $4,365.16 |
Aetna Setting Professional Modifier None Typical Low $47.86 Median $53.70 Typical High $91.20 | Professional | None | $47.86 | $53.70 | $91.20 |
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 $45.71 Median $53.70 Typical High $75.86 | Professional | None | $45.71 | $53.70 | $75.86 |
Cigna Setting Facility Modifier None Typical Low $26.92 Median $33.11 Typical High $549.54 | Facility | None | $26.92 | $33.11 | $549.54 |
Cigna Setting Professional Modifier None Typical Low $42.66 Median $75.86 Typical High $102.33 | Professional | None | $42.66 | $75.86 | $102.33 |
Hometown Health Setting Professional Modifier None Typical Low $45.71 Median $97.72 Typical High $107.15 | Professional | None | $45.71 | $97.72 | $107.15 |
Hometown Health Setting Facility Modifier None Typical Low $26.92 Median $26.92 Typical High $26.92 | Facility | None | $26.92 | $26.92 | $26.92 |
Hometown Health Setting Professional Modifier None Typical Low $0.48 Median $39.81 Typical High $77.62 | Professional | None | $0.48 | $39.81 | $77.62 |
Select Health Setting Facility Modifier None Typical Low $38.02 Median $51.29 Typical High $4,265.80 | Facility | None | $38.02 | $51.29 | $4,265.80 |
Select Health Setting Professional Modifier None Typical Low $35.48 Median $52.48 Typical High $81.28 | Professional | None | $35.48 | $52.48 | $81.28 |
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 $42.66 Median $72.44 Typical High $104.71 | Professional | None | $42.66 | $72.44 | $104.71 |
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 $23.99 Median $26.92 Typical High $31.62 | Professional | 52 · Reduced service | $23.99 | $26.92 | $31.62 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $9.77 Median $10.72 Typical High $12.88 | Professional | 53 · Discontinued | $9.77 | $10.72 | $12.88 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $36.31 Median $39.81 Typical High $47.86 | Professional | 54 · Surgery only | $36.31 | $39.81 | $47.86 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $7.24 Median $7.94 Typical High $9.55 | Professional | 55 · Aftercare only | $7.24 | $7.94 | $9.55 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $4.79 Median $5.37 Typical High $6.31 | Professional | 56 · Pre-op care only | $4.79 | $5.37 | $6.31 |
Where Nevada sits
The same service costs 3.6 times more in Wyoming than in Florida. 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· 35th of 51
$72.44
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.