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 $263.03 Median $1,698.24 Typical High $4,365.16 | Facility | None | $263.03 | $1,698.24 | $4,365.16 |
Aetna Setting Professional Modifier None Typical Low $154.88 Median $234.42 Typical High $338.84 | Professional | None | $154.88 | $234.42 | $338.84 |
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 $165.96 Median $281.84 Typical High $426.58 | Professional | None | $165.96 | $281.84 | $426.58 |
Cigna Setting Facility Modifier None Typical Low $194.98 Median $229.09 Typical High $354.81 | Facility | None | $194.98 | $229.09 | $354.81 |
Cigna Setting Professional Modifier None Typical Low $144.54 Median $218.78 Typical High $346.74 | Professional | None | $144.54 | $218.78 | $346.74 |
Hometown Health Setting Professional Modifier None Typical Low $162.18 Median $239.88 Typical High $426.58 | Professional | None | $162.18 | $239.88 | $426.58 |
Hometown Health Setting Facility Modifier None Typical Low $208.93 Median $208.93 Typical High $208.93 | Facility | None | $208.93 | $208.93 | $208.93 |
Hometown Health Setting Professional Modifier None Typical Low $1.38 Median $223.87 Typical High $426.58 | Professional | None | $1.38 | $223.87 | $426.58 |
Select Health Setting Facility Modifier None Typical Low $147.91 Median $281.84 Typical High $4,265.80 | Facility | None | $147.91 | $281.84 | $4,265.80 |
Select Health Setting Professional Modifier None Typical Low $154.88 Median $154.88 Typical High $154.88 | Professional | None | $154.88 | $154.88 | $154.88 |
United Setting Facility Modifier None Typical Low $97.72 Median $245.47 Typical High $1,949.84 | Facility | None | $97.72 | $245.47 | $1,949.84 |
United Setting Professional Modifier None Typical Low $128.82 Median $229.09 Typical High $363.08 | Professional | None | $128.82 | $229.09 | $363.08 |
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 $77.62 Median $109.65 Typical High $138.04 | Professional | 52 · Reduced service | $77.62 | $109.65 | $138.04 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $30.90 Median $43.65 Typical High $54.95 | Professional | 53 · Discontinued | $30.90 | $43.65 | $54.95 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $114.82 Median $162.18 Typical High $204.17 | Professional | 54 · Surgery only | $114.82 | $162.18 | $204.17 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $22.91 Median $33.11 Typical High $40.74 | Professional | 55 · Aftercare only | $22.91 | $33.11 | $40.74 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $15.49 Median $21.88 Typical High $27.54 | Professional | 56 · Pre-op care only | $15.49 | $21.88 | $27.54 |
Aetna Setting Professional Modifier 78 · Unplanned return to OR Typical Low $107.15 Median $151.36 Typical High $190.55 | Professional | 78 · Unplanned return to OR | $107.15 | $151.36 | $190.55 |
Where Nevada sits
The same service costs 3.4 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· 36th of 51
$251
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.