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 $177.83 Median $1,698.24 Typical High $4,365.16 | Facility | None | $177.83 | $1,698.24 | $4,365.16 |
Aetna Setting Professional Modifier None Typical Low $144.54 Median $181.97 Typical High $323.59 | Professional | None | $144.54 | $181.97 | $323.59 |
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 $177.83 Median $239.88 Typical High $323.59 | Professional | None | $177.83 | $239.88 | $323.59 |
Cigna Setting Facility Modifier None Typical Low $134.90 Median $169.82 Typical High $549.54 | Facility | None | $134.90 | $169.82 | $549.54 |
Cigna Setting Professional Modifier None Typical Low $144.54 Median $169.82 Typical High $281.84 | Professional | None | $144.54 | $169.82 | $281.84 |
Hometown Health Setting Professional Modifier None Typical Low $147.91 Median $218.78 Typical High $331.13 | Professional | None | $147.91 | $218.78 | $331.13 |
Hometown Health Setting Facility Modifier None Typical Low $134.90 Median $134.90 Typical High $134.90 | Facility | None | $134.90 | $134.90 | $134.90 |
Hometown Health Setting Professional Modifier None Typical Low $1.26 Median $204.17 Typical High $331.13 | Professional | None | $1.26 | $204.17 | $331.13 |
Select Health Setting Facility Modifier None Typical Low $169.82 Median $218.78 Typical High $4,265.80 | Facility | None | $169.82 | $218.78 | $4,265.80 |
Select Health Setting Professional Modifier None Typical Low $181.97 Median $181.97 Typical High $181.97 | Professional | None | $181.97 | $181.97 | $181.97 |
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 $138.04 Median $190.55 Typical High $302.00 | Professional | None | $138.04 | $190.55 | $302.00 |
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 $83.18 Median $87.10 Typical High $102.33 | Professional | 52 · Reduced service | $83.18 | $87.10 | $102.33 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $33.88 Median $35.48 Typical High $40.74 | Professional | 53 · Discontinued | $33.88 | $35.48 | $40.74 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $125.89 Median $131.83 Typical High $154.88 | Professional | 54 · Surgery only | $125.89 | $131.83 | $154.88 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $25.12 Median $26.30 Typical High $30.90 | Professional | 55 · Aftercare only | $25.12 | $26.30 | $30.90 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $16.98 Median $17.78 Typical High $20.42 | Professional | 56 · Pre-op care only | $16.98 | $17.78 | $20.42 |
Aetna Setting Professional Modifier 78 · Unplanned return to OR Typical Low $117.49 Median $123.03 Typical High $144.54 | Professional | 78 · Unplanned return to OR | $117.49 | $123.03 | $144.54 |
Where Nevada sits
The same service costs 4.4 times more in Alaska 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
$209
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.