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 $251.19 Median $302.00 Typical High $398.11 | Professional | None | $251.19 | $302.00 | $398.11 |
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 $269.15 Median $363.08 Typical High $524.81 | Professional | None | $269.15 | $363.08 | $524.81 |
Cigna Setting Facility Modifier None Typical Low $218.78 Median $275.42 Typical High $549.54 | Facility | None | $218.78 | $275.42 | $549.54 |
Cigna Setting Professional Modifier None Typical Low $229.09 Median $288.40 Typical High $467.74 | Professional | None | $229.09 | $288.40 | $467.74 |
Hometown Health Setting Professional Modifier None Typical Low $239.88 Median $354.81 Typical High $512.86 | Professional | None | $239.88 | $354.81 | $512.86 |
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 $3.31 Median $323.59 Typical High $512.86 | Professional | None | $3.31 | $323.59 | $512.86 |
Select Health Setting Facility Modifier None Typical Low $239.88 Median $338.84 Typical High $4,265.80 | Facility | None | $239.88 | $338.84 | $4,265.80 |
Select Health Setting Professional Modifier None Typical Low $251.19 Median $251.19 Typical High $251.19 | Professional | None | $251.19 | $251.19 | $251.19 |
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 $223.87 Median $338.84 Typical High $512.86 | Professional | None | $223.87 | $338.84 | $512.86 |
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 $125.89 Median $141.25 Typical High $162.18 | Professional | 52 · Reduced service | $125.89 | $141.25 | $162.18 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $50.12 Median $56.23 Typical High $64.57 | Professional | 53 · Discontinued | $50.12 | $56.23 | $64.57 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $186.21 Median $208.93 Typical High $245.47 | Professional | 54 · Surgery only | $186.21 | $208.93 | $245.47 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $37.15 Median $41.69 Typical High $48.98 | Professional | 55 · Aftercare only | $37.15 | $41.69 | $48.98 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $25.12 Median $28.18 Typical High $32.36 | Professional | 56 · Pre-op care only | $25.12 | $28.18 | $32.36 |
Aetna Setting Professional Modifier 78 · Unplanned return to OR Typical Low $173.78 Median $194.98 Typical High $229.09 | Professional | 78 · Unplanned return to OR | $173.78 | $194.98 | $229.09 |
Where Nevada sits
The same service costs 4.7 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· 33rd of 51
$339
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.