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 $138.04 Median $1,698.24 Typical High $4,365.16 | Facility | None | $138.04 | $1,698.24 | $4,365.16 |
Aetna Setting Professional Modifier None Typical Low $83.18 Median $125.89 Typical High $199.53 | Professional | None | $83.18 | $125.89 | $199.53 |
Ambetter Setting Professional Modifier None Typical Low $141.25 Median $141.25 Typical High $302.00 | Professional | None | $141.25 | $141.25 | $302.00 |
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 $147.91 Typical High $223.87 | Professional | None | $102.33 | $147.91 | $223.87 |
Cigna Setting Facility Modifier None Typical Low $112.20 Median $131.83 Typical High $204.17 | Facility | None | $112.20 | $131.83 | $204.17 |
Cigna Setting Professional Modifier None Typical Low $77.62 Median $117.49 Typical High $190.55 | Professional | None | $77.62 | $117.49 | $190.55 |
Hometown Health Setting Professional Modifier None Typical Low $112.20 Median $147.91 Typical High $234.42 | Professional | None | $112.20 | $147.91 | $234.42 |
Hometown Health Setting Facility Modifier None Typical Low $117.49 Median $117.49 Typical High $117.49 | Facility | None | $117.49 | $117.49 | $117.49 |
Hometown Health Setting Professional Modifier None Typical Low $0.78 Median $151.36 Typical High $234.42 | Professional | None | $0.78 | $151.36 | $234.42 |
Select Health Setting Facility Modifier None Typical Low $102.33 Median $154.88 Typical High $4,265.80 | Facility | None | $102.33 | $154.88 | $4,265.80 |
Select Health Setting Professional Modifier None Typical Low $107.15 Median $107.15 Typical High $107.15 | Professional | None | $107.15 | $107.15 | $107.15 |
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 $74.13 Median $125.89 Typical High $204.17 | Professional | None | $74.13 | $125.89 | $204.17 |
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 $46.77 Median $56.23 Typical High $72.44 | Professional | 52 · Reduced service | $46.77 | $56.23 | $72.44 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $18.62 Median $22.39 Typical High $28.84 | Professional | 53 · Discontinued | $18.62 | $22.39 | $28.84 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $70.79 Median $83.18 Typical High $107.15 | Professional | 54 · Surgery only | $70.79 | $83.18 | $107.15 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $14.13 Median $16.60 Typical High $21.38 | Professional | 55 · Aftercare only | $14.13 | $16.60 | $21.38 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $9.33 Median $11.22 Typical High $14.45 | Professional | 56 · Pre-op care only | $9.33 | $11.22 | $14.45 |
Aetna Setting Professional Modifier 78 · Unplanned return to OR Typical Low $66.07 Median $77.62 Typical High $100.00 | Professional | 78 · Unplanned return to OR | $66.07 | $77.62 | $100.00 |
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· 39th of 51
$141
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.