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 $269.15 Median $2,238.72 Typical High $5,011.87 | Facility | None | $269.15 | $2,238.72 | $5,011.87 |
Aetna Setting Professional Modifier None Typical Low $251.19 Median $331.13 Typical High $478.63 | Professional | None | $251.19 | $331.13 | $478.63 |
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 $275.42 Median $398.11 Typical High $575.44 | Professional | None | $275.42 | $398.11 | $575.44 |
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 $239.88 Median $331.13 Typical High $512.86 | Professional | None | $239.88 | $331.13 | $512.86 |
Hometown Health Setting Professional Modifier None Typical Low $263.03 Median $426.58 Typical High $851.14 | Professional | None | $263.03 | $426.58 | $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 $3.98 Median $354.81 Typical High $1,174.90 | Professional | None | $3.98 | $354.81 | $1,174.90 |
Select Health Setting Facility Modifier None Typical Low $234.42 Median $389.05 Typical High $4,265.80 | Facility | None | $234.42 | $389.05 | $4,265.80 |
Select Health Setting Professional Modifier None Typical Low $251.19 Median $251.19 Typical High $251.19 | Professional | None | $251.19 | $251.19 | $251.19 |
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 $263.03 Median $354.81 Typical High $501.19 | Professional | None | $263.03 | $354.81 | $501.19 |
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 $128.82 Median $158.49 Typical High $186.21 | Professional | 52 · Reduced service | $128.82 | $158.49 | $186.21 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $51.29 Median $63.10 Typical High $74.13 | Professional | 53 · Discontinued | $51.29 | $63.10 | $74.13 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $194.98 Median $239.88 Typical High $281.84 | Professional | 54 · Surgery only | $194.98 | $239.88 | $281.84 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $38.90 Median $47.86 Typical High $56.23 | Professional | 55 · Aftercare only | $38.90 | $47.86 | $56.23 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $25.70 Median $31.62 Typical High $37.15 | Professional | 56 · Pre-op care only | $25.70 | $31.62 | $37.15 |
Aetna Setting Professional Modifier 78 · Unplanned return to OR Typical Low $181.97 Median $223.87 Typical High $263.03 | Professional | 78 · Unplanned return to OR | $181.97 | $223.87 | $263.03 |
Where Nevada sits
The same service costs 3.9 times more in Alaska than in Utah. 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· 33rd of 51
$398
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.