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 $100.00 Median $1,698.24 Typical High $4,365.16 | Facility | None | $100.00 | $1,698.24 | $4,365.16 |
Aetna Setting Professional Modifier None Typical Low $93.33 Median $128.82 Typical High $199.53 | Professional | None | $93.33 | $128.82 | $199.53 |
Ambetter Setting Professional Modifier None Typical Low $66.07 Median $79.43 Typical High $107.15 | Professional | None | $66.07 | $79.43 | $107.15 |
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 $154.88 Typical High $234.42 | Professional | None | $102.33 | $154.88 | $234.42 |
Cigna Setting Facility Modifier None Typical Low $112.20 Median $141.25 Typical High $549.54 | Facility | None | $112.20 | $141.25 | $549.54 |
Cigna Setting Professional Modifier None Typical Low $87.10 Median $123.03 Typical High $194.98 | Professional | None | $87.10 | $123.03 | $194.98 |
Hometown Health Setting Professional Modifier None Typical Low $102.33 Median $141.25 Typical High $234.42 | Professional | None | $102.33 | $141.25 | $234.42 |
Hometown Health Setting Facility Modifier None Typical Low $112.20 Median $112.20 Typical High $112.20 | Facility | None | $112.20 | $112.20 | $112.20 |
Hometown Health Setting Professional Modifier None Typical Low $0.78 Median $141.25 Typical High $229.09 | Professional | None | $0.78 | $141.25 | $229.09 |
Select Health Setting Facility Modifier None Typical Low $93.33 Median $154.88 Typical High $4,265.80 | Facility | None | $93.33 | $154.88 | $4,265.80 |
Select Health Setting Professional Modifier None Typical Low $97.72 Median $97.72 Typical High $97.72 | Professional | None | $97.72 | $97.72 | $97.72 |
United Setting Facility Modifier None Typical Low $97.72 Median $234.42 Typical High $1,949.84 | Facility | None | $97.72 | $234.42 | $1,949.84 |
United Setting Professional Modifier None Typical Low $77.62 Median $125.89 Typical High $199.53 | Professional | None | $77.62 | $125.89 | $199.53 |
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 $58.88 Typical High $75.86 | Professional | 52 · Reduced service | $47.86 | $58.88 | $75.86 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $19.50 Median $23.44 Typical High $30.20 | Professional | 53 · Discontinued | $19.50 | $23.44 | $30.20 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $72.44 Median $89.13 Typical High $112.20 | Professional | 54 · Surgery only | $72.44 | $89.13 | $112.20 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $14.45 Median $17.78 Typical High $22.39 | Professional | 55 · Aftercare only | $14.45 | $17.78 | $22.39 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $9.55 Median $11.75 Typical High $15.14 | Professional | 56 · Pre-op care only | $9.55 | $11.75 | $15.14 |
Aetna Setting Professional Modifier 78 · Unplanned return to OR Typical Low $67.61 Median $83.18 Typical High $104.71 | Professional | 78 · Unplanned return to OR | $67.61 | $83.18 | $104.71 |
Where Nevada sits
The same service costs 3.7 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· 35th of 51
$145
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.