How much rates vary
Facilitymedian $1,318 · 10th to 90th $468 to $4,365Professionalmedian $219 · 10th to 90th $158 to $347
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 $218.78 Median $2,238.72 Typical High $5,011.87 | Facility | None | $218.78 | $2,238.72 | $5,011.87 |
Aetna Setting Professional Modifier None Typical Low $158.49 Median $199.53 Typical High $275.42 | Professional | None | $158.49 | $199.53 | $275.42 |
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 $173.78 Median $245.47 Typical High $346.74 | Professional | None | $173.78 | $245.47 | $346.74 |
Cigna Setting Facility Modifier None Typical Low $501.19 Median $812.83 Typical High $1,122.02 | Facility | None | $501.19 | $812.83 | $1,122.02 |
Cigna Setting Professional Modifier None Typical Low $147.91 Median $194.98 Typical High $309.03 | Professional | None | $147.91 | $194.98 | $309.03 |
Hometown Health Setting Professional Modifier None Typical Low $177.83 Median $263.03 Typical High $851.14 | Professional | None | $177.83 | $263.03 | $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 $1.70 Median $245.47 Typical High $1,174.90 | Professional | None | $1.70 | $245.47 | $1,174.90 |
Select Health Setting Facility Modifier None Typical Low $162.18 Median $239.88 Typical High $4,265.80 | Facility | None | $162.18 | $239.88 | $4,265.80 |
Select Health Setting Professional Modifier None Typical Low $169.82 Median $169.82 Typical High $169.82 | Professional | None | $169.82 | $169.82 | $169.82 |
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 $147.91 Median $213.80 Typical High $323.59 | Professional | None | $147.91 | $213.80 | $323.59 |
7 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 $81.28 Median $91.20 Typical High $112.20 | Professional | 52 · Reduced service | $81.28 | $91.20 | $112.20 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $32.36 Median $37.15 Typical High $45.71 | Professional | 53 · Discontinued | $32.36 | $37.15 | $45.71 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $123.03 Median $138.04 Typical High $169.82 | Professional | 54 · Surgery only | $123.03 | $138.04 | $169.82 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $24.55 Median $27.54 Typical High $33.88 | Professional | 55 · Aftercare only | $24.55 | $27.54 | $33.88 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $16.22 Median $18.20 Typical High $22.91 | Professional | 56 · Pre-op care only | $16.22 | $18.20 | $22.91 |
Aetna Setting Professional Modifier 78 · Unplanned return to OR Typical Low $114.82 Median $128.82 Typical High $158.49 | Professional | 78 · Unplanned return to OR | $114.82 | $128.82 | $158.49 |
Ambetter Setting Professional Modifier 79 · Unrelated procedure after surgery Typical Low $102.33 Median $102.33 Typical High $102.33 | Professional | 79 · Unrelated procedure after surgery | $102.33 | $102.33 | $102.33 |
Where Nevada sits
The same service costs 4.7 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· 34th of 51
$240
AK $871KY $186
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.