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 $158.49 Median $1,698.24 Typical High $4,365.16 | Facility | None | $158.49 | $1,698.24 | $4,365.16 |
Aetna Setting Professional Modifier None Typical Low $151.36 Median $213.80 Typical High $251.19 | Professional | None | $151.36 | $213.80 | $251.19 |
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 $162.18 Median $239.88 Typical High $363.08 | Professional | None | $162.18 | $239.88 | $363.08 |
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 $147.91 Median $204.17 Typical High $309.03 | Professional | None | $147.91 | $204.17 | $309.03 |
Hometown Health Setting Professional Modifier None Typical Low $151.36 Median $213.80 Typical High $363.08 | Professional | None | $151.36 | $213.80 | $363.08 |
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 $2.24 Median $204.17 Typical High $354.81 | Professional | None | $2.24 | $204.17 | $354.81 |
Select Health Setting Facility Modifier None Typical Low $138.04 Median $239.88 Typical High $4,265.80 | Facility | None | $138.04 | $239.88 | $4,265.80 |
Select Health Setting Professional Modifier None Typical Low $144.54 Median $144.54 Typical High $144.54 | Professional | None | $144.54 | $144.54 | $144.54 |
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 $158.49 Median $223.87 Typical High $309.03 | Professional | None | $158.49 | $223.87 | $309.03 |
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 $75.86 Median $100.00 Typical High $117.49 | Professional | 52 · Reduced service | $75.86 | $100.00 | $117.49 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $30.20 Median $39.81 Typical High $46.77 | Professional | 53 · Discontinued | $30.20 | $39.81 | $46.77 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $112.20 Median $151.36 Typical High $173.78 | Professional | 54 · Surgery only | $112.20 | $151.36 | $173.78 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $22.91 Median $30.20 Typical High $34.67 | Professional | 55 · Aftercare only | $22.91 | $30.20 | $34.67 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $15.14 Median $19.95 Typical High $23.44 | Professional | 56 · Pre-op care only | $15.14 | $19.95 | $23.44 |
Aetna Setting Professional Modifier 78 · Unplanned return to OR Typical Low $104.71 Median $141.25 Typical High $162.18 | Professional | 78 · Unplanned return to OR | $104.71 | $141.25 | $162.18 |
Where Nevada sits
The same service costs 3.5 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· 36th of 51
$229
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.