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 $234.42 Median $1,698.24 Typical High $4,365.16 | Facility | None | $234.42 | $1,698.24 | $4,365.16 |
Aetna Setting Professional Modifier None Typical Low $89.13 Median $144.54 Typical High $309.03 | Professional | None | $89.13 | $144.54 | $309.03 |
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 $102.33 Median $208.93 Typical High $371.54 | Professional | None | $102.33 | $208.93 | $371.54 |
Cigna Setting Facility Modifier None Typical Low $223.87 Median $257.04 Typical High $398.11 | Facility | None | $223.87 | $257.04 | $398.11 |
Cigna Setting Professional Modifier None Typical Low $85.11 Median $147.91 Typical High $281.84 | Professional | None | $85.11 | $147.91 | $281.84 |
Hometown Health Setting Professional Modifier None Typical Low $114.82 Median $204.17 Typical High $407.38 | Professional | None | $114.82 | $204.17 | $407.38 |
Hometown Health Setting Facility Modifier None Typical Low $234.42 Median $234.42 Typical High $234.42 | Facility | None | $234.42 | $234.42 | $234.42 |
Hometown Health Setting Professional Modifier None Typical Low $0.60 Median $158.49 Typical High $407.38 | Professional | None | $0.60 | $158.49 | $407.38 |
Select Health Setting Facility Modifier None Typical Low $104.71 Median $269.15 Typical High $4,265.80 | Facility | None | $104.71 | $269.15 | $4,265.80 |
Select Health Setting Professional Modifier None Typical Low $109.65 Median $109.65 Typical High $109.65 | Professional | None | $109.65 | $109.65 | $109.65 |
United Setting Facility Modifier None Typical Low $302.00 Median $512.86 Typical High $2,137.96 | Facility | None | $302.00 | $512.86 | $2,137.96 |
United Setting Professional Modifier None Typical Low $75.86 Median $158.49 Typical High $309.03 | Professional | None | $75.86 | $158.49 | $309.03 |
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 $47.86 Median $69.18 Typical High $123.03 | Professional | 52 · Reduced service | $47.86 | $69.18 | $123.03 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $19.50 Median $27.54 Typical High $50.12 | Professional | 53 · Discontinued | $19.50 | $27.54 | $50.12 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $72.44 Median $104.71 Typical High $186.21 | Professional | 54 · Surgery only | $72.44 | $104.71 | $186.21 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $14.45 Median $20.89 Typical High $37.15 | Professional | 55 · Aftercare only | $14.45 | $20.89 | $37.15 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $9.55 Median $13.80 Typical High $24.55 | Professional | 56 · Pre-op care only | $9.55 | $13.80 | $24.55 |
Aetna Setting Professional Modifier 78 · Unplanned return to OR Typical Low $67.61 Median $97.72 Typical High $173.78 | Professional | 78 · Unplanned return to OR | $67.61 | $97.72 | $173.78 |
Where Nevada sits
The same service costs 4.1 times more in Alaska 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· 24th 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.