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 $104.71 Median $1,698.24 Typical High $4,365.16 | Facility | None | $104.71 | $1,698.24 | $4,365.16 |
Aetna Setting Professional Modifier None Typical Low $102.33 Median $162.18 Typical High $257.04 | Professional | None | $102.33 | $162.18 | $257.04 |
Ambetter Setting Professional Modifier None Typical Low $141.25 Median $141.25 Typical High $151.36 | Professional | None | $141.25 | $141.25 | $151.36 |
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 $100.00 Median $158.49 Typical High $239.88 | Professional | None | $100.00 | $158.49 | $239.88 |
Cigna Setting Facility Modifier None Typical Low $107.15 Median $131.83 Typical High $549.54 | Facility | None | $107.15 | $131.83 | $549.54 |
Cigna Setting Professional Modifier None Typical Low $114.82 Median $162.18 Typical High $229.09 | Professional | None | $114.82 | $162.18 | $229.09 |
Hometown Health Setting Professional Modifier None Typical Low $102.33 Median $177.83 Typical High $245.47 | Professional | None | $102.33 | $177.83 | $245.47 |
Hometown Health Setting Facility Modifier None Typical Low $107.15 Median $107.15 Typical High $107.15 | Facility | None | $107.15 | $107.15 | $107.15 |
Hometown Health Setting Professional Modifier None Typical Low $2.00 Median $141.25 Typical High $234.42 | Professional | None | $2.00 | $141.25 | $234.42 |
Select Health Setting Facility Modifier None Typical Low $93.33 Median $158.49 Typical High $4,265.80 | Facility | None | $93.33 | $158.49 | $4,265.80 |
Select Health Setting Professional Modifier None Typical Low $97.72 Median $97.72 Typical High $97.72 | Professional | None | $97.72 | $97.72 | $97.72 |
United Setting Facility Modifier None Typical Low $97.72 Median $234.42 Typical High $1,949.84 | Facility | None | $97.72 | $234.42 | $1,949.84 |
United Setting Professional Modifier None Typical Low $104.71 Median $165.96 Typical High $234.42 | Professional | None | $104.71 | $165.96 | $234.42 |
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 $50.12 Median $69.18 Typical High $83.18 | Professional | 52 · Reduced service | $50.12 | $69.18 | $83.18 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $20.42 Median $28.18 Typical High $33.11 | Professional | 53 · Discontinued | $20.42 | $28.18 | $33.11 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $75.86 Median $104.71 Typical High $125.89 | Professional | 54 · Surgery only | $75.86 | $104.71 | $125.89 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $15.14 Median $20.89 Typical High $25.12 | Professional | 55 · Aftercare only | $15.14 | $20.89 | $25.12 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $10.23 Median $14.13 Typical High $16.60 | Professional | 56 · Pre-op care only | $10.23 | $14.13 | $16.60 |
Aetna Setting Professional Modifier 78 · Unplanned return to OR Typical Low $70.79 Median $97.72 Typical High $117.49 | Professional | 78 · Unplanned return to OR | $70.79 | $97.72 | $117.49 |
Where Nevada sits
The same service costs 3.2 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· 37th of 51
$170
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.