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 $229.09 Median $2,238.72 Typical High $5,011.87 | Facility | None | $229.09 | $2,238.72 | $5,011.87 |
Aetna Setting Professional Modifier None Typical Low $208.93 Median $281.84 Typical High $407.38 | Professional | None | $208.93 | $281.84 | $407.38 |
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 $229.09 Median $331.13 Typical High $501.19 | Professional | None | $229.09 | $331.13 | $501.19 |
Cigna Setting Facility Modifier None Typical Low $501.19 Median $812.83 Typical High $1,122.02 | Facility | None | $501.19 | $812.83 | $1,122.02 |
Cigna Setting Professional Modifier None Typical Low $199.53 Median $281.84 Typical High $426.58 | Professional | None | $199.53 | $281.84 | $426.58 |
Hometown Health Setting Professional Modifier None Typical Low $218.78 Median $371.54 Typical High $851.14 | Professional | None | $218.78 | $371.54 | $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 $2.95 Median $302.00 Typical High $1,174.90 | Professional | None | $2.95 | $302.00 | $1,174.90 |
Select Health Setting Facility Modifier None Typical Low $199.53 Median $338.84 Typical High $4,265.80 | Facility | None | $199.53 | $338.84 | $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 $467.74 Median $724.44 Typical High $2,884.03 | Facility | None | $467.74 | $724.44 | $2,884.03 |
United Setting Professional Modifier None Typical Low $218.78 Median $302.00 Typical High $489.78 | Professional | None | $218.78 | $302.00 | $489.78 |
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 $109.65 Median $134.90 Typical High $162.18 | Professional | 52 · Reduced service | $109.65 | $134.90 | $162.18 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $43.65 Median $53.70 Typical High $64.57 | Professional | 53 · Discontinued | $43.65 | $53.70 | $64.57 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $162.18 Median $204.17 Typical High $245.47 | Professional | 54 · Surgery only | $162.18 | $204.17 | $245.47 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $32.36 Median $40.74 Typical High $48.98 | Professional | 55 · Aftercare only | $32.36 | $40.74 | $48.98 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $21.88 Median $26.92 Typical High $32.36 | Professional | 56 · Pre-op care only | $21.88 | $26.92 | $32.36 |
Aetna Setting Professional Modifier 78 · Unplanned return to OR Typical Low $151.36 Median $190.55 Typical High $229.09 | Professional | 78 · Unplanned return to OR | $151.36 | $190.55 | $229.09 |
Where Nevada sits
The same service costs 4.0 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· 34th of 51
$339
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.