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 $234.42 Median $2,570.40 Typical High $5,011.87 | Facility | None | $234.42 | $2,570.40 | $5,011.87 |
Aetna Setting Professional Modifier None Typical Low $223.87 Median $338.84 Typical High $478.63 | Professional | None | $223.87 | $338.84 | $478.63 |
Ambetter Setting Professional Modifier None Typical Low $302.00 Median $354.81 Typical High $467.74 | Professional | None | $302.00 | $354.81 | $467.74 |
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 $239.88 Median $398.11 Typical High $588.84 | Professional | None | $239.88 | $398.11 | $588.84 |
Cigna Setting Facility Modifier None Typical Low $426.58 Median $512.86 Typical High $741.31 | Facility | None | $426.58 | $512.86 | $741.31 |
Cigna Setting Professional Modifier None Typical Low $229.09 Median $331.13 Typical High $489.78 | Professional | None | $229.09 | $331.13 | $489.78 |
Hometown Health Setting Professional Modifier None Typical Low $229.09 Median $426.58 Typical High $588.84 | Professional | None | $229.09 | $426.58 | $588.84 |
Hometown Health Setting Facility Modifier None Typical Low $426.58 Median $426.58 Typical High $426.58 | Facility | None | $426.58 | $426.58 | $426.58 |
Hometown Health Setting Professional Modifier None Typical Low $1.62 Median $309.03 Typical High $630.96 | Professional | None | $1.62 | $309.03 | $630.96 |
Select Health Setting Facility Modifier None Typical Low $208.93 Median $389.05 Typical High $4,265.80 | Facility | None | $208.93 | $389.05 | $4,265.80 |
Select Health Setting Professional Modifier None Typical Low $218.78 Median $218.78 Typical High $218.78 | Professional | None | $218.78 | $218.78 | $218.78 |
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 $204.17 Median $338.84 Typical High $501.19 | Professional | None | $204.17 | $338.84 | $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 $112.20 Median $162.18 Typical High $190.55 | Professional | 52 · Reduced service | $112.20 | $162.18 | $190.55 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $44.67 Median $64.57 Typical High $77.62 | Professional | 53 · Discontinued | $44.67 | $64.57 | $77.62 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $169.82 Median $245.47 Typical High $288.40 | Professional | 54 · Surgery only | $169.82 | $245.47 | $288.40 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $33.88 Median $48.98 Typical High $57.54 | Professional | 55 · Aftercare only | $33.88 | $48.98 | $57.54 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $22.39 Median $32.36 Typical High $38.02 | Professional | 56 · Pre-op care only | $22.39 | $32.36 | $38.02 |
Aetna Setting Professional Modifier 78 · Unplanned return to OR Typical Low $158.49 Median $229.09 Typical High $269.15 | Professional | 78 · Unplanned return to OR | $158.49 | $229.09 | $269.15 |
Where Nevada sits
The same service costs 3.3 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· 35th of 51
$372
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.