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 $288.40 Median $1,698.24 Typical High $4,365.16 | Facility | None | $288.40 | $1,698.24 | $4,365.16 |
Aetna Setting Professional Modifier None Typical Low $181.97 Median $263.03 Typical High $389.05 | Professional | None | $181.97 | $263.03 | $389.05 |
Ambetter Setting Professional Modifier None Typical Low $186.21 Median $186.21 Typical High $186.21 | Professional | None | $186.21 | $186.21 | $186.21 |
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 $194.98 Median $316.23 Typical High $467.74 | Professional | None | $194.98 | $316.23 | $467.74 |
Cigna Setting Facility Modifier None Typical Low $204.17 Median $239.88 Typical High $371.54 | Facility | None | $204.17 | $239.88 | $371.54 |
Cigna Setting Professional Modifier None Typical Low $173.78 Median $251.19 Typical High $380.19 | Professional | None | $173.78 | $251.19 | $380.19 |
Hometown Health Setting Professional Modifier None Typical Low $186.21 Median $269.15 Typical High $467.74 | Professional | None | $186.21 | $269.15 | $467.74 |
Hometown Health Setting Facility Modifier None Typical Low $218.78 Median $218.78 Typical High $218.78 | Facility | None | $218.78 | $218.78 | $218.78 |
Hometown Health Setting Professional Modifier None Typical Low $1.45 Median $257.04 Typical High $467.74 | Professional | None | $1.45 | $257.04 | $467.74 |
Select Health Setting Facility Modifier None Typical Low $169.82 Median $309.03 Typical High $4,265.80 | Facility | None | $169.82 | $309.03 | $4,265.80 |
Select Health Setting Professional Modifier None Typical Low $177.83 Median $177.83 Typical High $177.83 | Professional | None | $177.83 | $177.83 | $177.83 |
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 $158.49 Median $251.19 Typical High $407.38 | Professional | None | $158.49 | $251.19 | $407.38 |
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 $91.20 Median $125.89 Typical High $151.36 | Professional | 52 · Reduced service | $91.20 | $125.89 | $151.36 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $36.31 Median $50.12 Typical High $60.26 | Professional | 53 · Discontinued | $36.31 | $50.12 | $60.26 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $134.90 Median $186.21 Typical High $229.09 | Professional | 54 · Surgery only | $134.90 | $186.21 | $229.09 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $26.92 Median $37.15 Typical High $45.71 | Professional | 55 · Aftercare only | $26.92 | $37.15 | $45.71 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $18.20 Median $25.12 Typical High $30.20 | Professional | 56 · Pre-op care only | $18.20 | $25.12 | $30.20 |
Aetna Setting Professional Modifier 78 · Unplanned return to OR Typical Low $125.89 Median $173.78 Typical High $213.80 | Professional | 78 · Unplanned return to OR | $125.89 | $173.78 | $213.80 |
Where Nevada sits
The same service costs 3.7 times more in Alaska than in Maryland. 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
$282
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.