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 $204.17 Median $2,238.72 Typical High $5,011.87 | Facility | None | $204.17 | $2,238.72 | $5,011.87 |
Aetna Setting Professional Modifier None Typical Low $186.21 Median $257.04 Typical High $371.54 | Professional | None | $186.21 | $257.04 | $371.54 |
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 $208.93 Median $309.03 Typical High $457.09 | Professional | None | $208.93 | $309.03 | $457.09 |
Cigna Setting Facility Modifier None Typical Low $398.11 Median $467.74 Typical High $691.83 | Facility | None | $398.11 | $467.74 | $691.83 |
Cigna Setting Professional Modifier None Typical Low $177.83 Median $263.03 Typical High $389.05 | Professional | None | $177.83 | $263.03 | $389.05 |
Hometown Health Setting Professional Modifier None Typical Low $194.98 Median $338.84 Typical High $489.78 | Professional | None | $194.98 | $338.84 | $489.78 |
Hometown Health Setting Facility Modifier None Typical Low $407.38 Median $407.38 Typical High $407.38 | Facility | None | $407.38 | $407.38 | $407.38 |
Hometown Health Setting Professional Modifier None Typical Low $1.62 Median $269.15 Typical High $602.56 | Professional | None | $1.62 | $269.15 | $602.56 |
Select Health Setting Facility Modifier None Typical Low $177.83 Median $309.03 Typical High $4,265.80 | Facility | None | $177.83 | $309.03 | $4,265.80 |
Select Health Setting Professional Modifier None Typical Low $186.21 Median $186.21 Typical High $186.21 | Professional | None | $186.21 | $186.21 | $186.21 |
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 $190.55 Median $263.03 Typical High $398.11 | Professional | None | $190.55 | $263.03 | $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 $97.72 Median $125.89 Typical High $147.91 | Professional | 52 · Reduced service | $97.72 | $125.89 | $147.91 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $38.90 Median $50.12 Typical High $60.26 | Professional | 53 · Discontinued | $38.90 | $50.12 | $60.26 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $144.54 Median $186.21 Typical High $223.87 | Professional | 54 · Surgery only | $144.54 | $186.21 | $223.87 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $28.84 Median $37.15 Typical High $44.67 | Professional | 55 · Aftercare only | $28.84 | $37.15 | $44.67 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $19.50 Median $25.12 Typical High $29.51 | Professional | 56 · Pre-op care only | $19.50 | $25.12 | $29.51 |
Aetna Setting Professional Modifier 78 · Unplanned return to OR Typical Low $134.90 Median $173.78 Typical High $208.93 | Professional | 78 · Unplanned return to OR | $134.90 | $173.78 | $208.93 |
Where Nevada sits
The same service costs 3.6 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· 29th of 51
$309
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.