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 $162.18 Median $1,698.24 Typical High $4,365.16 | Facility | None | $162.18 | $1,698.24 | $4,365.16 |
Aetna Setting Professional Modifier None Typical Low $151.36 Median $213.80 Typical High $309.03 | Professional | None | $151.36 | $213.80 | $309.03 |
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 $165.96 Median $251.19 Typical High $371.54 | Professional | None | $165.96 | $251.19 | $371.54 |
Cigna Setting Facility Modifier None Typical Low $169.82 Median $213.80 Typical High $549.54 | Facility | None | $169.82 | $213.80 | $549.54 |
Cigna Setting Professional Modifier None Typical Low $144.54 Median $213.80 Typical High $316.23 | Professional | None | $144.54 | $213.80 | $316.23 |
Hometown Health Setting Professional Modifier None Typical Low $154.88 Median $218.78 Typical High $371.54 | Professional | None | $154.88 | $218.78 | $371.54 |
Hometown Health Setting Facility Modifier None Typical Low $169.82 Median $169.82 Typical High $169.82 | Facility | None | $169.82 | $169.82 | $169.82 |
Hometown Health Setting Professional Modifier None Typical Low $2.00 Median $213.80 Typical High $371.54 | Professional | None | $2.00 | $213.80 | $371.54 |
Select Health Setting Facility Modifier None Typical Low $141.25 Median $251.19 Typical High $4,265.80 | Facility | None | $141.25 | $251.19 | $4,265.80 |
Select Health Setting Professional Modifier None Typical Low $151.36 Median $151.36 Typical High $151.36 | Professional | None | $151.36 | $151.36 | $151.36 |
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 $154.88 Median $223.87 Typical High $323.59 | Professional | None | $154.88 | $223.87 | $323.59 |
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 $75.86 Median $104.71 Typical High $120.23 | Professional | 52 · Reduced service | $75.86 | $104.71 | $120.23 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $30.90 Median $41.69 Typical High $48.98 | Professional | 53 · Discontinued | $30.90 | $41.69 | $48.98 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $114.82 Median $154.88 Typical High $181.97 | Professional | 54 · Surgery only | $114.82 | $154.88 | $181.97 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $22.91 Median $30.90 Typical High $36.31 | Professional | 55 · Aftercare only | $22.91 | $30.90 | $36.31 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $15.49 Median $20.89 Typical High $23.99 | Professional | 56 · Pre-op care only | $15.49 | $20.89 | $23.99 |
Aetna Setting Professional Modifier 78 · Unplanned return to OR Typical Low $107.15 Median $144.54 Typical High $169.82 | Professional | 78 · Unplanned return to OR | $107.15 | $144.54 | $169.82 |
Where Nevada sits
The same service costs 3.4 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· 38th of 51
$240
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.