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 $104.71 Median $2,238.72 Typical High $5,011.87 | Facility | None | $104.71 | $2,238.72 | $5,011.87 |
Aetna Setting Professional Modifier None Typical Low $100.00 Median $134.90 Typical High $208.93 | Professional | None | $100.00 | $134.90 | $208.93 |
Ambetter Setting Professional Modifier None Typical Low $67.61 Median $72.44 Typical High $81.28 | Professional | None | $67.61 | $72.44 | $81.28 |
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 $107.15 Median $158.49 Typical High $239.88 | Professional | None | $107.15 | $158.49 | $239.88 |
Cigna Setting Facility Modifier None Typical Low $112.20 Median $138.04 Typical High $549.54 | Facility | None | $112.20 | $138.04 | $549.54 |
Cigna Setting Professional Modifier None Typical Low $93.33 Median $131.83 Typical High $199.53 | Professional | None | $93.33 | $131.83 | $199.53 |
Hometown Health Setting Professional Modifier None Typical Low $107.15 Median $147.91 Typical High $239.88 | Professional | None | $107.15 | $147.91 | $239.88 |
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 $0.83 Median $147.91 Typical High $239.88 | Professional | None | $0.83 | $147.91 | $239.88 |
Select Health Setting Facility Modifier None Typical Low $97.72 Median $158.49 Typical High $4,265.80 | Facility | None | $97.72 | $158.49 | $4,265.80 |
Select Health Setting Professional Modifier None Typical Low $102.33 Median $102.33 Typical High $102.33 | Professional | None | $102.33 | $102.33 | $102.33 |
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 $87.10 Median $134.90 Typical High $204.17 | Professional | None | $87.10 | $134.90 | $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 $50.12 Median $63.10 Typical High $77.62 | Professional | 52 · Reduced service | $50.12 | $63.10 | $77.62 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $19.95 Median $25.12 Typical High $30.90 | Professional | 53 · Discontinued | $19.95 | $25.12 | $30.90 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $74.13 Median $93.33 Typical High $114.82 | Professional | 54 · Surgery only | $74.13 | $93.33 | $114.82 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $14.79 Median $18.62 Typical High $22.91 | Professional | 55 · Aftercare only | $14.79 | $18.62 | $22.91 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $10.00 Median $12.59 Typical High $15.49 | Professional | 56 · Pre-op care only | $10.00 | $12.59 | $15.49 |
Aetna Setting Professional Modifier 78 · Unplanned return to OR Typical Low $69.18 Median $87.10 Typical High $107.15 | Professional | 78 · Unplanned return to OR | $69.18 | $87.10 | $107.15 |
Where Nevada sits
The same service costs 3.5 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· 34th of 51
$155
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.