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 $316.23 Median $2,137.96 Typical High $10,715.19 | Facility | None | $316.23 | $2,137.96 | $10,715.19 |
Aetna Setting Professional Modifier None Typical Low $316.23 Median $398.11 Typical High $426.58 | Professional | None | $316.23 | $398.11 | $426.58 |
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 $338.84 Median $467.74 Typical High $691.83 | Professional | None | $338.84 | $467.74 | $691.83 |
Cigna Setting Facility Modifier None Typical Low $234.42 Median $288.40 Typical High $549.54 | Facility | None | $234.42 | $288.40 | $549.54 |
Cigna Setting Professional Modifier None Typical Low $316.23 Median $407.38 Typical High $602.56 | Professional | None | $316.23 | $407.38 | $602.56 |
Hometown Health Setting Professional Modifier None Typical Low $269.15 Median $436.52 Typical High $660.69 | Professional | None | $269.15 | $436.52 | $660.69 |
Hometown Health Setting Facility Modifier None Typical Low $234.42 Median $234.42 Typical High $234.42 | Facility | None | $234.42 | $234.42 | $234.42 |
Hometown Health Setting Professional Modifier None Typical Low $1.32 Median $346.74 Typical High $660.69 | Professional | None | $1.32 | $346.74 | $660.69 |
Select Health Setting Facility Modifier None Typical Low $302.00 Median $436.52 Typical High $4,265.80 | Facility | None | $302.00 | $436.52 | $4,265.80 |
Select Health Setting Professional Modifier None Typical Low $323.59 Median $323.59 Typical High $323.59 | Professional | None | $323.59 | $323.59 | $323.59 |
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 $295.12 Median $436.52 Typical High $660.69 | Professional | None | $295.12 | $436.52 | $660.69 |
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 $158.49 Median $190.55 Typical High $213.80 | Professional | 52 · Reduced service | $158.49 | $190.55 | $213.80 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $63.10 Median $77.62 Typical High $85.11 | Professional | 53 · Discontinued | $63.10 | $77.62 | $85.11 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $239.88 Median $288.40 Typical High $316.23 | Professional | 54 · Surgery only | $239.88 | $288.40 | $316.23 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $47.86 Median $57.54 Typical High $64.57 | Professional | 55 · Aftercare only | $47.86 | $57.54 | $64.57 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $31.62 Median $38.02 Typical High $42.66 | Professional | 56 · Pre-op care only | $31.62 | $38.02 | $42.66 |
Aetna Setting Professional Modifier 78 · Unplanned return to OR Typical Low $223.87 Median $269.15 Typical High $295.12 | Professional | 78 · Unplanned return to OR | $223.87 | $269.15 | $295.12 |
Where Nevada sits
The same service costs 6.0 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· 36th of 51
$427
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.