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 $131.83 Median $165.96 Typical High $234.42 | Professional | None | $131.83 | $165.96 | $234.42 |
Ambetter Setting Professional Modifier None Typical Low $114.82 Median $114.82 Typical High $114.82 | Professional | None | $114.82 | $114.82 | $114.82 |
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 $141.25 Median $204.17 Typical High $288.40 | Professional | None | $141.25 | $204.17 | $288.40 |
Cigna Setting Facility Modifier None Typical Low $134.90 Median $169.82 Typical High $549.54 | Facility | None | $134.90 | $169.82 | $549.54 |
Cigna Setting Professional Modifier None Typical Low $123.03 Median $158.49 Typical High $251.19 | Professional | None | $123.03 | $158.49 | $251.19 |
Hometown Health Setting Professional Modifier None Typical Low $144.54 Median $194.98 Typical High $288.40 | Professional | None | $144.54 | $194.98 | $288.40 |
Hometown Health Setting Facility Modifier None Typical Low $134.90 Median $134.90 Typical High $134.90 | Facility | None | $134.90 | $134.90 | $134.90 |
Hometown Health Setting Professional Modifier None Typical Low $1.32 Median $194.98 Typical High $288.40 | Professional | None | $1.32 | $194.98 | $288.40 |
Select Health Setting Facility Modifier None Typical Low $131.83 Median $194.98 Typical High $4,265.80 | Facility | None | $131.83 | $194.98 | $4,265.80 |
Select Health Setting Professional Modifier None Typical Low $138.04 Median $138.04 Typical High $138.04 | Professional | None | $138.04 | $138.04 | $138.04 |
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 $112.20 Median $169.82 Typical High $263.03 | Professional | None | $112.20 | $169.82 | $263.03 |
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 $66.07 Median $75.86 Typical High $93.33 | Professional | 52 · Reduced service | $66.07 | $75.86 | $93.33 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $26.92 Median $30.20 Typical High $37.15 | Professional | 53 · Discontinued | $26.92 | $30.20 | $37.15 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $100.00 Median $112.20 Typical High $141.25 | Professional | 54 · Surgery only | $100.00 | $112.20 | $141.25 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $19.95 Median $22.39 Typical High $28.18 | Professional | 55 · Aftercare only | $19.95 | $22.39 | $28.18 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $13.49 Median $15.14 Typical High $18.62 | Professional | 56 · Pre-op care only | $13.49 | $15.14 | $18.62 |
Aetna Setting Professional Modifier 78 · Unplanned return to OR Typical Low $93.33 Median $104.71 Typical High $131.83 | Professional | 78 · Unplanned return to OR | $93.33 | $104.71 | $131.83 |
Where Nevada sits
The same service costs 3.9 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· 33rd of 51
$191
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.