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 $50.12 Median $2,137.96 Typical High $10,715.19 | Facility | None | $50.12 | $2,137.96 | $10,715.19 |
Aetna Setting Professional Modifier None Typical Low $50.12 Median $75.86 Typical High $120.23 | Professional | None | $50.12 | $75.86 | $120.23 |
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 $50.12 Median $75.86 Typical High $128.82 | Professional | None | $50.12 | $75.86 | $128.82 |
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 $52.48 Median $83.18 Typical High $134.90 | Professional | None | $52.48 | $83.18 | $134.90 |
Hometown Health Setting Professional Modifier None Typical Low $50.12 Median $77.62 Typical High $162.18 | Professional | None | $50.12 | $77.62 | $162.18 |
Hometown Health Setting Professional Modifier None Typical Low $0.24 Median $66.07 Typical High $117.49 | Professional | None | $0.24 | $66.07 | $117.49 |
Select Health Setting Facility Modifier None Typical Low $43.65 Median $77.62 Typical High $4,265.80 | Facility | None | $43.65 | $77.62 | $4,265.80 |
Select Health Setting Professional Modifier None Typical Low $70.79 Median $70.79 Typical High $70.79 | Professional | None | $70.79 | $70.79 | $70.79 |
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 $50.12 Median $79.43 Typical High $141.25 | Professional | None | $50.12 | $79.43 | $141.25 |
6 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 $25.12 Median $36.31 Typical High $39.81 | Professional | 52 · Reduced service | $25.12 | $36.31 | $39.81 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $10.00 Median $14.45 Typical High $15.85 | Professional | 53 · Discontinued | $10.00 | $14.45 | $15.85 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $38.02 Median $54.95 Typical High $58.88 | Professional | 54 · Surgery only | $38.02 | $54.95 | $58.88 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $7.59 Median $10.96 Typical High $11.75 | Professional | 55 · Aftercare only | $7.59 | $10.96 | $11.75 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $5.01 Median $7.24 Typical High $7.94 | Professional | 56 · Pre-op care only | $5.01 | $7.24 | $7.94 |
Ambetter Setting Professional Modifier 50 · Both sides Typical Low $144.54 Median $144.54 Typical High $144.54 | Professional | 50 · Both sides | $144.54 | $144.54 | $144.54 |
Where Nevada sits
The same service costs 3.2 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· 47th of 51
$81.28
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.