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 $194.98 Median $2,238.72 Typical High $5,011.87 | Facility | None | $194.98 | $2,238.72 | $5,011.87 |
Aetna Setting Professional Modifier None Typical Low $186.21 Median $251.19 Typical High $302.00 | Professional | None | $186.21 | $251.19 | $302.00 |
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 $186.21 Median $288.40 Typical High $436.52 | Professional | None | $186.21 | $288.40 | $436.52 |
Cigna Setting Facility Modifier None Typical Low $186.21 Median $213.80 Typical High $338.84 | Facility | None | $186.21 | $213.80 | $338.84 |
Cigna Setting Professional Modifier None Typical Low $154.88 Median $229.09 Typical High $354.81 | Professional | None | $154.88 | $229.09 | $354.81 |
Hometown Health Setting Professional Modifier None Typical Low $190.55 Median $263.03 Typical High $446.68 | Professional | None | $190.55 | $263.03 | $446.68 |
Hometown Health Setting Facility Modifier None Typical Low $194.98 Median $194.98 Typical High $194.98 | Facility | None | $194.98 | $194.98 | $194.98 |
Hometown Health Setting Professional Modifier None Typical Low $2.82 Median $257.04 Typical High $436.52 | Professional | None | $2.82 | $257.04 | $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 $181.97 Median $181.97 Typical High $181.97 | Professional | None | $181.97 | $181.97 | $181.97 |
United Setting Facility Modifier None Typical Low $467.74 Median $776.25 Typical High $2,884.03 | Facility | None | $467.74 | $776.25 | $2,884.03 |
United Setting Professional Modifier None Typical Low $186.21 Median $245.47 Typical High $380.19 | Professional | None | $186.21 | $245.47 | $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 $109.65 Typical High $151.36 | Professional | 52 · Reduced service | $95.50 | $109.65 | $151.36 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $38.02 Median $43.65 Typical High $60.26 | Professional | 53 · Discontinued | $38.02 | $43.65 | $60.26 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $144.54 Median $165.96 Typical High $229.09 | Professional | 54 · Surgery only | $144.54 | $165.96 | $229.09 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $28.84 Median $33.11 Typical High $45.71 | Professional | 55 · Aftercare only | $28.84 | $33.11 | $45.71 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $19.05 Median $21.88 Typical High $30.20 | Professional | 56 · Pre-op care only | $19.05 | $21.88 | $30.20 |
Aetna Setting Professional Modifier 78 · Unplanned return to OR Typical Low $134.90 Median $154.88 Typical High $213.80 | Professional | 78 · Unplanned return to OR | $134.90 | $154.88 | $213.80 |
Where Nevada sits
The same service costs 3.5 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· 31st of 51
$288
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.