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 $66.07 Median $1,698.24 Typical High $4,365.16 | Facility | None | $66.07 | $1,698.24 | $4,365.16 |
Aetna Setting Professional Modifier None Typical Low $61.66 Median $81.28 Typical High $123.03 | Professional | None | $61.66 | $81.28 | $123.03 |
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 $69.18 Median $100.00 Typical High $147.91 | Professional | None | $69.18 | $100.00 | $147.91 |
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 $57.54 Median $79.43 Typical High $128.82 | Professional | None | $57.54 | $79.43 | $128.82 |
Hometown Health Setting Professional Modifier None Typical Low $64.57 Median $95.50 Typical High $144.54 | Professional | None | $64.57 | $95.50 | $144.54 |
Hometown Health Setting Professional Modifier None Typical Low $0.78 Median $87.10 Typical High $144.54 | Professional | None | $0.78 | $87.10 | $144.54 |
Select Health Setting Facility Modifier None Typical Low $58.88 Median $95.50 Typical High $4,265.80 | Facility | None | $58.88 | $95.50 | $4,265.80 |
Select Health Setting Professional Modifier None Typical Low $61.66 Median $61.66 Typical High $61.66 | Professional | None | $61.66 | $61.66 | $61.66 |
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 $64.57 Median $87.10 Typical High $125.89 | Professional | None | $64.57 | $87.10 | $125.89 |
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 $31.62 Median $38.90 Typical High $47.86 | Professional | 52 · Reduced service | $31.62 | $38.90 | $47.86 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $12.88 Median $15.49 Typical High $19.05 | Professional | 53 · Discontinued | $12.88 | $15.49 | $19.05 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $47.86 Median $57.54 Typical High $70.79 | Professional | 54 · Surgery only | $47.86 | $57.54 | $70.79 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $9.55 Median $11.75 Typical High $14.45 | Professional | 55 · Aftercare only | $9.55 | $11.75 | $14.45 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $6.31 Median $7.76 Typical High $9.55 | Professional | 56 · Pre-op care only | $6.31 | $7.76 | $9.55 |
Aetna Setting Professional Modifier 78 · Unplanned return to OR Typical Low $44.67 Median $53.70 Typical High $66.07 | Professional | 78 · Unplanned return to OR | $44.67 | $53.70 | $66.07 |
Where Nevada sits
The same service costs 3.8 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· 32nd of 51
$95.50
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.