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 $218.78 Median $1,698.24 Typical High $4,365.16 | Facility | None | $218.78 | $1,698.24 | $4,365.16 |
Aetna Setting Professional Modifier None Typical Low $199.53 Median $245.47 Typical High $338.84 | Professional | None | $199.53 | $245.47 | $338.84 |
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 $218.78 Median $302.00 Typical High $436.52 | Professional | None | $218.78 | $302.00 | $436.52 |
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 $190.55 Median $234.42 Typical High $380.19 | Professional | None | $190.55 | $234.42 | $380.19 |
Hometown Health Setting Professional Modifier None Typical Low $218.78 Median $316.23 Typical High $851.14 | Professional | None | $218.78 | $316.23 | $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 $1.91 Median $295.12 Typical High $1,174.90 | Professional | None | $1.91 | $295.12 | $1,174.90 |
Select Health Setting Facility Modifier None Typical Low $199.53 Median $288.40 Typical High $4,265.80 | Facility | None | $199.53 | $288.40 | $4,265.80 |
Select Health Setting Professional Modifier None Typical Low $208.93 Median $208.93 Typical High $208.93 | Professional | None | $208.93 | $208.93 | $208.93 |
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 $181.97 Median $257.04 Typical High $398.11 | Professional | None | $181.97 | $257.04 | $398.11 |
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 $102.33 Median $114.82 Typical High $138.04 | Professional | 52 · Reduced service | $102.33 | $114.82 | $138.04 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $41.69 Median $45.71 Typical High $54.95 | Professional | 53 · Discontinued | $41.69 | $45.71 | $54.95 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $154.88 Median $169.82 Typical High $204.17 | Professional | 54 · Surgery only | $154.88 | $169.82 | $204.17 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $30.90 Median $33.88 Typical High $40.74 | Professional | 55 · Aftercare only | $30.90 | $33.88 | $40.74 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $20.89 Median $22.91 Typical High $27.54 | Professional | 56 · Pre-op care only | $20.89 | $22.91 | $27.54 |
Aetna Setting Professional Modifier 78 · Unplanned return to OR Typical Low $144.54 Median $158.49 Typical High $190.55 | Professional | 78 · Unplanned return to OR | $144.54 | $158.49 | $190.55 |
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· 31st of 51
$295
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.