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 $144.54 Median $2,238.72 Typical High $5,011.87 | Facility | None | $144.54 | $2,238.72 | $5,011.87 |
Aetna Setting Professional Modifier None Typical Low $138.04 Median $204.17 Typical High $263.03 | Professional | None | $138.04 | $204.17 | $263.03 |
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 $147.91 Median $234.42 Typical High $346.74 | Professional | None | $147.91 | $234.42 | $346.74 |
Cigna Setting Facility Modifier None Typical Low $151.36 Median $190.55 Typical High $549.54 | Facility | None | $151.36 | $190.55 | $549.54 |
Cigna Setting Professional Modifier None Typical Low $134.90 Median $194.98 Typical High $295.12 | Professional | None | $134.90 | $194.98 | $295.12 |
Hometown Health Setting Professional Modifier None Typical Low $138.04 Median $194.98 Typical High $346.74 | Professional | None | $138.04 | $194.98 | $346.74 |
Hometown Health Setting Facility Modifier None Typical Low $151.36 Median $151.36 Typical High $151.36 | Facility | None | $151.36 | $151.36 | $151.36 |
Hometown Health Setting Professional Modifier None Typical Low $2.04 Median $190.55 Typical High $346.74 | Professional | None | $2.04 | $190.55 | $346.74 |
Select Health Setting Facility Modifier None Typical Low $125.89 Median $229.09 Typical High $4,265.80 | Facility | None | $125.89 | $229.09 | $4,265.80 |
Select Health Setting Professional Modifier None Typical Low $131.83 Median $131.83 Typical High $131.83 | Professional | None | $131.83 | $131.83 | $131.83 |
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 $144.54 Median $208.93 Typical High $295.12 | Professional | None | $144.54 | $208.93 | $295.12 |
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 $69.18 Median $95.50 Typical High $112.20 | Professional | 52 · Reduced service | $69.18 | $95.50 | $112.20 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $27.54 Median $38.02 Typical High $44.67 | Professional | 53 · Discontinued | $27.54 | $38.02 | $44.67 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $104.71 Median $141.25 Typical High $169.82 | Professional | 54 · Surgery only | $104.71 | $141.25 | $169.82 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $20.89 Median $28.18 Typical High $33.88 | Professional | 55 · Aftercare only | $20.89 | $28.18 | $33.88 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $13.80 Median $19.05 Typical High $22.39 | Professional | 56 · Pre-op care only | $13.80 | $19.05 | $22.39 |
Aetna Setting Professional Modifier 78 · Unplanned return to OR Typical Low $97.72 Median $131.83 Typical High $158.49 | Professional | 78 · Unplanned return to OR | $97.72 | $131.83 | $158.49 |
Where Nevada sits
The same service costs 3.5 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· 38th of 51
$214
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.