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 $158.49 Median $1,698.24 Typical High $4,365.16 | Facility | None | $158.49 | $1,698.24 | $4,365.16 |
Aetna Setting Professional Modifier None Typical Low $144.54 Median $190.55 Typical High $295.12 | Professional | None | $144.54 | $190.55 | $295.12 |
Ambetter Setting Professional Modifier None Typical Low $97.72 Median $97.72 Typical High $97.72 | Professional | None | $97.72 | $97.72 | $97.72 |
Anthem BCBS Setting Facility Modifier None Typical Low $2,570.40 Median $3,801.89 Typical High $5,128.61 | Facility | None | $2,570.40 | $3,801.89 | $5,128.61 |
Anthem BCBS Setting Professional Modifier None Typical Low $162.18 Median $234.42 Typical High $338.84 | Professional | None | $162.18 | $234.42 | $338.84 |
Cigna Setting Facility Modifier None Typical Low $398.11 Median $776.25 Typical High $1,122.02 | Facility | None | $398.11 | $776.25 | $1,122.02 |
Cigna Setting Professional Modifier None Typical Low $134.90 Median $181.97 Typical High $281.84 | Professional | None | $134.90 | $181.97 | $281.84 |
Hometown Health Setting Professional Modifier None Typical Low $165.96 Median $245.47 Typical High $851.14 | Professional | None | $165.96 | $245.47 | $851.14 |
Hometown Health Setting Facility Modifier None Typical Low $776.25 Median $776.25 Typical High $776.25 | Facility | None | $776.25 | $776.25 | $776.25 |
Hometown Health Setting Professional Modifier None Typical Low $1.20 Median $223.87 Typical High $1,174.90 | Professional | None | $1.20 | $223.87 | $1,174.90 |
Select Health Setting Facility Modifier None Typical Low $151.36 Median $229.09 Typical High $4,265.80 | Facility | None | $151.36 | $229.09 | $4,265.80 |
Select Health Setting Professional Modifier None Typical Low $158.49 Median $158.49 Typical High $158.49 | Professional | None | $158.49 | $158.49 | $158.49 |
United Setting Facility Modifier None Typical Low $467.74 Median $724.44 Typical High $2,884.03 | Facility | None | $467.74 | $724.44 | $2,884.03 |
United Setting Professional Modifier None Typical Low $134.90 Median $194.98 Typical High $295.12 | Professional | None | $134.90 | $194.98 | $295.12 |
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 $75.86 Median $85.11 Typical High $109.65 | Professional | 52 · Reduced service | $75.86 | $85.11 | $109.65 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $30.20 Median $33.88 Typical High $43.65 | Professional | 53 · Discontinued | $30.20 | $33.88 | $43.65 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $112.20 Median $128.82 Typical High $162.18 | Professional | 54 · Surgery only | $112.20 | $128.82 | $162.18 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $22.39 Median $25.70 Typical High $32.36 | Professional | 55 · Aftercare only | $22.39 | $25.70 | $32.36 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $15.14 Median $16.98 Typical High $21.88 | Professional | 56 · Pre-op care only | $15.14 | $16.98 | $21.88 |
Aetna Setting Professional Modifier 78 · Unplanned return to OR Typical Low $104.71 Median $120.23 Typical High $151.36 | Professional | 78 · Unplanned return to OR | $104.71 | $120.23 | $151.36 |
Where Nevada sits
The same service costs 4.6 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· 29th of 51
$229
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.