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 $186.21 Median $2,137.96 Typical High $10,715.19 | Facility | None | $186.21 | $2,137.96 | $10,715.19 |
Aetna Setting Professional Modifier None Typical Low $186.21 Median $302.00 Typical High $380.19 | Professional | None | $186.21 | $302.00 | $380.19 |
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 $208.93 Median $331.13 Typical High $501.19 | Professional | None | $208.93 | $331.13 | $501.19 |
Cigna Setting Facility Modifier None Typical Low $54.95 Median $741.31 Typical High $2,137.96 | Facility | None | $54.95 | $741.31 | $2,137.96 |
Cigna Setting Professional Modifier None Typical Low $194.98 Median $323.59 Typical High $524.81 | Professional | None | $194.98 | $323.59 | $524.81 |
Hometown Health Setting Professional Modifier None Typical Low $208.93 Median $331.13 Typical High $512.86 | Professional | None | $208.93 | $331.13 | $512.86 |
Hometown Health Setting Professional Modifier None Typical Low $3.31 Median $288.40 Typical High $489.78 | Professional | None | $3.31 | $288.40 | $489.78 |
Select Health Setting Facility Modifier None Typical Low $190.55 Median $331.13 Typical High $4,265.80 | Facility | None | $190.55 | $331.13 | $4,265.80 |
Select Health Setting Professional Modifier None Typical Low $199.53 Median $199.53 Typical High $199.53 | Professional | None | $199.53 | $199.53 | $199.53 |
United Setting Facility Modifier None Typical Low $302.00 Median $512.86 Typical High $2,137.96 | Facility | None | $302.00 | $512.86 | $2,137.96 |
United Setting Professional Modifier None Typical Low $213.80 Median $338.84 Typical High $478.63 | Professional | None | $213.80 | $338.84 | $478.63 |
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 $93.33 Median $141.25 Typical High $158.49 | Professional | 52 · Reduced service | $93.33 | $141.25 | $158.49 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $38.02 Median $56.23 Typical High $63.10 | Professional | 53 · Discontinued | $38.02 | $56.23 | $63.10 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $141.25 Median $208.93 Typical High $239.88 | Professional | 54 · Surgery only | $141.25 | $208.93 | $239.88 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $28.18 Median $42.66 Typical High $47.86 | Professional | 55 · Aftercare only | $28.18 | $42.66 | $47.86 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $18.62 Median $28.18 Typical High $31.62 | Professional | 56 · Pre-op care only | $18.62 | $28.18 | $31.62 |
Aetna Setting Professional Modifier 78 · Unplanned return to OR Typical Low $131.83 Median $194.98 Typical High $223.87 | Professional | 78 · Unplanned return to OR | $131.83 | $194.98 | $223.87 |
Where Nevada sits
The same service costs 4.1 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· 31st of 51
$347
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.