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 $181.97 Median $1,698.24 Typical High $4,365.16 | Facility | None | $181.97 | $1,698.24 | $4,365.16 |
Aetna Setting Professional Modifier None Typical Low $169.82 Median $239.88 Typical High $346.74 | Professional | None | $169.82 | $239.88 | $346.74 |
Ambetter Setting Professional Modifier None Typical Low $125.89 Median $165.96 Typical High $165.96 | Professional | None | $125.89 | $165.96 | $165.96 |
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 $186.21 Median $275.42 Typical High $416.87 | Professional | None | $186.21 | $275.42 | $416.87 |
Cigna Setting Facility Modifier None Typical Low $181.97 Median $229.09 Typical High $549.54 | Facility | None | $181.97 | $229.09 | $549.54 |
Cigna Setting Professional Modifier None Typical Low $162.18 Median $234.42 Typical High $354.81 | Professional | None | $162.18 | $234.42 | $354.81 |
Hometown Health Setting Professional Modifier None Typical Low $177.83 Median $245.47 Typical High $416.87 | Professional | None | $177.83 | $245.47 | $416.87 |
Hometown Health Setting Facility Modifier None Typical Low $181.97 Median $181.97 Typical High $181.97 | Facility | None | $181.97 | $181.97 | $181.97 |
Hometown Health Setting Professional Modifier None Typical Low $1.32 Median $239.88 Typical High $407.38 | Professional | None | $1.32 | $239.88 | $407.38 |
Select Health Setting Facility Modifier None Typical Low $162.18 Median $275.42 Typical High $4,265.80 | Facility | None | $162.18 | $275.42 | $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 $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 $173.78 Median $239.88 Typical High $354.81 | Professional | None | $173.78 | $239.88 | $354.81 |
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 $87.10 Median $112.20 Typical High $134.90 | Professional | 52 · Reduced service | $87.10 | $112.20 | $134.90 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $35.48 Median $45.71 Typical High $53.70 | Professional | 53 · Discontinued | $35.48 | $45.71 | $53.70 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $131.83 Median $169.82 Typical High $199.53 | Professional | 54 · Surgery only | $131.83 | $169.82 | $199.53 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $26.30 Median $33.88 Typical High $39.81 | Professional | 55 · Aftercare only | $26.30 | $33.88 | $39.81 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $17.38 Median $22.91 Typical High $26.92 | Professional | 56 · Pre-op care only | $17.38 | $22.91 | $26.92 |
Aetna Setting Professional Modifier 78 · Unplanned return to OR Typical Low $123.03 Median $158.49 Typical High $186.21 | Professional | 78 · Unplanned return to OR | $123.03 | $158.49 | $186.21 |
Where Nevada sits
The same service costs 3.6 times more in Alaska than in Texas. 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· 35th of 51
$263
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.