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 $81.28 Median $1,698.24 Typical High $4,365.16 | Facility | None | $81.28 | $1,698.24 | $4,365.16 |
Aetna Setting Professional Modifier None Typical Low $77.62 Median $120.23 Typical High $165.96 | Professional | None | $77.62 | $120.23 | $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 $83.18 Median $138.04 Typical High $208.93 | Professional | None | $83.18 | $138.04 | $208.93 |
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 $75.86 Median $117.49 Typical High $173.78 | Professional | None | $75.86 | $117.49 | $173.78 |
Hometown Health Setting Professional Modifier None Typical Low $81.28 Median $125.89 Typical High $208.93 | Professional | None | $81.28 | $125.89 | $208.93 |
Hometown Health Setting Professional Modifier None Typical Low $0.95 Median $109.65 Typical High $208.93 | Professional | None | $0.95 | $109.65 | $208.93 |
Select Health Setting Facility Modifier None Typical Low $74.13 Median $138.04 Typical High $4,265.80 | Facility | None | $74.13 | $138.04 | $4,265.80 |
Select Health Setting Professional Modifier None Typical Low $77.62 Median $77.62 Typical High $77.62 | Professional | None | $77.62 | $77.62 | $77.62 |
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 $81.28 Median $125.89 Typical High $177.83 | Professional | None | $81.28 | $125.89 | $177.83 |
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 $38.90 Median $57.54 Typical High $66.07 | Professional | 52 · Reduced service | $38.90 | $57.54 | $66.07 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $15.49 Median $22.91 Typical High $26.92 | Professional | 53 · Discontinued | $15.49 | $22.91 | $26.92 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $57.54 Median $87.10 Typical High $100.00 | Professional | 54 · Surgery only | $57.54 | $87.10 | $100.00 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $11.75 Median $17.38 Typical High $19.95 | Professional | 55 · Aftercare only | $11.75 | $17.38 | $19.95 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $7.76 Median $11.48 Typical High $13.18 | Professional | 56 · Pre-op care only | $7.76 | $11.48 | $13.18 |
Aetna Setting Professional Modifier 78 · Unplanned return to OR Typical Low $53.70 Median $81.28 Typical High $93.33 | Professional | 78 · Unplanned return to OR | $53.70 | $81.28 | $93.33 |
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· 34th of 51
$132
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.