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 $89.13 Median $1,698.24 Typical High $4,365.16 | Facility | None | $89.13 | $1,698.24 | $4,365.16 |
Aetna Setting Professional Modifier None Typical Low $85.11 Median $125.89 Typical High $165.96 | Professional | None | $85.11 | $125.89 | $165.96 |
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 $91.20 Median $147.91 Typical High $218.78 | Professional | None | $91.20 | $147.91 | $218.78 |
Cigna Setting Facility Modifier None Typical Low $97.72 Median $112.20 Typical High $177.83 | Facility | None | $97.72 | $112.20 | $177.83 |
Cigna Setting Professional Modifier None Typical Low $83.18 Median $125.89 Typical High $186.21 | Professional | None | $83.18 | $125.89 | $186.21 |
Hometown Health Setting Professional Modifier None Typical Low $89.13 Median $125.89 Typical High $218.78 | Professional | None | $89.13 | $125.89 | $218.78 |
Hometown Health Setting Facility Modifier None Typical Low $102.33 Median $102.33 Typical High $102.33 | Facility | None | $102.33 | $102.33 | $102.33 |
Hometown Health Setting Professional Modifier None Typical Low $1.07 Median $120.23 Typical High $218.78 | Professional | None | $1.07 | $120.23 | $218.78 |
Select Health Setting Facility Modifier None Typical Low $81.28 Median $147.91 Typical High $4,265.80 | Facility | None | $81.28 | $147.91 | $4,265.80 |
Select Health Setting Professional Modifier None Typical Low $85.11 Median $85.11 Typical High $85.11 | Professional | None | $85.11 | $85.11 | $85.11 |
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 $89.13 Median $125.89 Typical High $190.55 | Professional | None | $89.13 | $125.89 | $190.55 |
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 $42.66 Median $61.66 Typical High $70.79 | Professional | 52 · Reduced service | $42.66 | $61.66 | $70.79 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $16.98 Median $24.55 Typical High $28.18 | Professional | 53 · Discontinued | $16.98 | $24.55 | $28.18 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $63.10 Median $91.20 Typical High $107.15 | Professional | 54 · Surgery only | $63.10 | $91.20 | $107.15 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $12.88 Median $18.20 Typical High $21.38 | Professional | 55 · Aftercare only | $12.88 | $18.20 | $21.38 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $8.51 Median $12.30 Typical High $14.13 | Professional | 56 · Pre-op care only | $8.51 | $12.30 | $14.13 |
Aetna Setting Professional Modifier 78 · Unplanned return to OR Typical Low $58.88 Median $85.11 Typical High $100.00 | Professional | 78 · Unplanned return to OR | $58.88 | $85.11 | $100.00 |
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· 36th of 51
$135
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.