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 $239.88 Median $239.88 Typical High $263.03 | Facility | None | $239.88 | $239.88 | $263.03 |
Aetna Setting Professional Modifier None Typical Low $190.55 Median $239.88 Typical High $309.03 | Professional | None | $190.55 | $239.88 | $309.03 |
Anthem BCBS Setting Professional Modifier None Typical Low $234.42 Median $281.84 Typical High $363.08 | Professional | None | $234.42 | $281.84 | $363.08 |
Cigna Setting Professional Modifier None Typical Low $154.88 Median $190.55 Typical High $302.00 | Professional | None | $154.88 | $190.55 | $302.00 |
Hometown Health Setting Professional Modifier None Typical Low $1.58 Median $204.17 Typical High $346.74 | Professional | None | $1.58 | $204.17 | $346.74 |
Hometown Health Setting Professional Modifier None Typical Low $1.58 Median $1.58 Typical High $323.59 | Professional | None | $1.58 | $1.58 | $323.59 |
Select Health Setting Facility Modifier None Typical Low $218.78 Median $218.78 Typical High $4,265.80 | Facility | None | $218.78 | $218.78 | $4,265.80 |
Select Health Setting Professional Modifier None Typical Low $229.09 Median $229.09 Typical High $229.09 | Professional | None | $229.09 | $229.09 | $229.09 |
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 $173.78 Median $218.78 Typical High $288.40 | Professional | None | $173.78 | $218.78 | $288.40 |
4 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 $112.20 Median $120.23 Typical High $131.83 | Professional | 52 · Reduced service | $112.20 | $120.23 | $131.83 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $44.67 Median $47.86 Typical High $52.48 | Professional | 53 · Discontinued | $44.67 | $47.86 | $52.48 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $33.88 Median $36.31 Typical High $38.90 | Professional | 55 · Aftercare only | $33.88 | $36.31 | $38.90 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $22.39 Median $23.99 Typical High $26.30 | Professional | 56 · Pre-op care only | $22.39 | $23.99 | $26.30 |
Where Nevada sits
The same service costs 3.0 times more in Wisconsin 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· 32nd of 51
$234
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.