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 $44.67 Median $2,137.96 Typical High $10,715.19 | Facility | None | $44.67 | $2,137.96 | $10,715.19 |
Aetna Setting Professional Modifier None Typical Low $41.69 Median $46.77 Typical High $53.70 | Professional | None | $41.69 | $46.77 | $53.70 |
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 $47.86 Median $58.88 Typical High $87.10 | Professional | None | $47.86 | $58.88 | $87.10 |
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 $39.81 Median $50.12 Typical High $69.18 | Professional | None | $39.81 | $50.12 | $69.18 |
Hometown Health Setting Professional Modifier None Typical Low $45.71 Median $56.23 Typical High $79.43 | Professional | None | $45.71 | $56.23 | $79.43 |
Hometown Health Setting Professional Modifier None Typical Low $0.42 Median $63.10 Typical High $79.43 | Professional | None | $0.42 | $63.10 | $79.43 |
Select Health Setting Facility Modifier None Typical Low $41.69 Median $52.48 Typical High $4,265.80 | Facility | None | $41.69 | $52.48 | $4,265.80 |
Select Health Setting Professional Modifier None Typical Low $43.65 Median $43.65 Typical High $43.65 | Professional | None | $43.65 | $43.65 | $43.65 |
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 $35.48 Median $50.12 Typical High $81.28 | Professional | None | $35.48 | $50.12 | $81.28 |
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 $22.39 Median $23.44 Typical High $25.12 | Professional | 52 · Reduced service | $22.39 | $23.44 | $25.12 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $8.91 Median $9.33 Typical High $10.00 | Professional | 53 · Discontinued | $8.91 | $9.33 | $10.00 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $33.88 Median $35.48 Typical High $38.02 | Professional | 54 · Surgery only | $33.88 | $35.48 | $38.02 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $6.76 Median $7.08 Typical High $7.59 | Professional | 55 · Aftercare only | $6.76 | $7.08 | $7.59 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $4.47 Median $4.68 Typical High $5.01 | Professional | 56 · Pre-op care only | $4.47 | $4.68 | $5.01 |
Aetna Setting Professional Modifier 78 · Unplanned return to OR Typical Low $31.62 Median $33.11 Typical High $35.48 | Professional | 78 · Unplanned return to OR | $31.62 | $33.11 | $35.48 |
Where Nevada sits
The same service costs 4.6 times more in Alaska than in New York. 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
$54.95
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.