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 $199.53 Median $1,698.24 Typical High $4,365.16 | Facility | None | $199.53 | $1,698.24 | $4,365.16 |
Aetna Setting Professional Modifier None Typical Low $186.21 Median $251.19 Typical High $354.81 | Professional | None | $186.21 | $251.19 | $354.81 |
Ambetter Setting Professional Modifier None Typical Low $354.81 Median $354.81 Typical High $354.81 | Professional | None | $354.81 | $354.81 | $354.81 |
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 $204.17 Median $295.12 Typical High $436.52 | Professional | None | $204.17 | $295.12 | $436.52 |
Cigna Setting Facility Modifier None Typical Low $181.97 Median $208.93 Typical High $741.31 | Facility | None | $181.97 | $208.93 | $741.31 |
Cigna Setting Professional Modifier None Typical Low $177.83 Median $251.19 Typical High $371.54 | Professional | None | $177.83 | $251.19 | $371.54 |
Hometown Health Setting Professional Modifier None Typical Low $194.98 Median $263.03 Typical High $446.68 | Professional | None | $194.98 | $263.03 | $446.68 |
Hometown Health Setting Facility Modifier None Typical Low $190.55 Median $190.55 Typical High $190.55 | Facility | None | $190.55 | $190.55 | $190.55 |
Hometown Health Setting Professional Modifier None Typical Low $2.45 Median $263.03 Typical High $436.52 | Professional | None | $2.45 | $263.03 | $436.52 |
Select Health Setting Facility Modifier None Typical Low $173.78 Median $295.12 Typical High $4,265.80 | Facility | None | $173.78 | $295.12 | $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 $194.98 Median $263.03 Typical High $380.19 | Professional | None | $194.98 | $263.03 | $380.19 |
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 $95.50 Median $120.23 Typical High $141.25 | Professional | 52 · Reduced service | $95.50 | $120.23 | $141.25 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $38.02 Median $47.86 Typical High $57.54 | Professional | 53 · Discontinued | $38.02 | $47.86 | $57.54 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $144.54 Median $181.97 Typical High $213.80 | Professional | 54 · Surgery only | $144.54 | $181.97 | $213.80 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $28.84 Median $36.31 Typical High $42.66 | Professional | 55 · Aftercare only | $28.84 | $36.31 | $42.66 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $19.05 Median $23.99 Typical High $28.18 | Professional | 56 · Pre-op care only | $19.05 | $23.99 | $28.18 |
Aetna Setting Professional Modifier 78 · Unplanned return to OR Typical Low $134.90 Median $169.82 Typical High $199.53 | Professional | 78 · Unplanned return to OR | $134.90 | $169.82 | $199.53 |
Where Nevada sits
The same service costs 3.9 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
$282
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.