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 $19.50 Median $2,137.96 Typical High $10,715.19 | Facility | None | $19.50 | $2,137.96 | $10,715.19 |
Aetna Setting Professional Modifier None Typical Low $19.50 Median $22.39 Typical High $51.29 | Professional | None | $19.50 | $22.39 | $51.29 |
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 $21.38 Median $24.55 Typical High $37.15 | Professional | None | $21.38 | $24.55 | $37.15 |
Cigna Setting Facility Modifier None Typical Low $54.95 Median $741.31 Typical High $2,137.96 | Facility | None | $54.95 | $741.31 | $2,137.96 |
Cigna Setting Professional Modifier None Typical Low $22.39 Median $42.66 Typical High $87.10 | Professional | None | $22.39 | $42.66 | $87.10 |
Hometown Health Setting Professional Modifier None Typical Low $23.99 Median $54.95 Typical High $58.88 | Professional | None | $23.99 | $54.95 | $58.88 |
Hometown Health Setting Professional Modifier None Typical Low $0.24 Median $28.18 Typical High $28.18 | Professional | None | $0.24 | $28.18 | $28.18 |
Select Health Setting Facility Modifier None Typical Low $18.62 Median $18.62 Typical High $4,265.80 | Facility | None | $18.62 | $18.62 | $4,265.80 |
Select Health Setting Professional Modifier None Typical Low $17.78 Median $25.12 Typical High $39.81 | Professional | None | $17.78 | $25.12 | $39.81 |
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 $22.39 Median $41.69 Typical High $64.57 | Professional | None | $22.39 | $41.69 | $64.57 |
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 $9.77 Median $11.22 Typical High $13.49 | Professional | 52 · Reduced service | $9.77 | $11.22 | $13.49 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $3.98 Median $4.47 Typical High $5.37 | Professional | 53 · Discontinued | $3.98 | $4.47 | $5.37 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $14.79 Median $16.98 Typical High $19.95 | Professional | 54 · Surgery only | $14.79 | $16.98 | $19.95 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $2.95 Median $3.39 Typical High $3.98 | Professional | 55 · Aftercare only | $2.95 | $3.39 | $3.98 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $1.95 Median $2.24 Typical High $2.69 | Professional | 56 · Pre-op care only | $1.95 | $2.24 | $2.69 |
Where Nevada sits
The same service costs 4.3 times more in Wyoming than in New York. 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· 31st of 51
$41.69
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.