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 $83.18 Median $2,137.96 Typical High $10,715.19 | Facility | None | $83.18 | $2,137.96 | $10,715.19 |
Aetna Setting Professional Modifier None Typical Low $83.18 Median $109.65 Typical High $134.90 | Professional | None | $83.18 | $109.65 | $134.90 |
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 $89.13 Median $125.89 Typical High $186.21 | Professional | None | $89.13 | $125.89 | $186.21 |
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 $83.18 Median $109.65 Typical High $158.49 | Professional | None | $83.18 | $109.65 | $158.49 |
Hometown Health Setting Professional Modifier None Typical Low $85.11 Median $125.89 Typical High $181.97 | Professional | None | $85.11 | $125.89 | $181.97 |
Hometown Health Setting Professional Modifier None Typical Low $0.89 Median $114.82 Typical High $181.97 | Professional | None | $0.89 | $114.82 | $181.97 |
Select Health Setting Facility Modifier None Typical Low $75.86 Median $120.23 Typical High $4,265.80 | Facility | None | $75.86 | $120.23 | $4,265.80 |
Select Health Setting Professional Modifier None Typical Low $81.28 Median $81.28 Typical High $81.28 | Professional | None | $81.28 | $81.28 | $81.28 |
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 $69.18 Median $112.20 Typical High $173.78 | Professional | None | $69.18 | $112.20 | $173.78 |
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 $41.69 Median $52.48 Typical High $57.54 | Professional | 52 · Reduced service | $41.69 | $52.48 | $57.54 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $16.60 Median $21.38 Typical High $22.91 | Professional | 53 · Discontinued | $16.60 | $21.38 | $22.91 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $61.66 Median $79.43 Typical High $87.10 | Professional | 54 · Surgery only | $61.66 | $79.43 | $87.10 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $12.30 Median $15.85 Typical High $17.38 | Professional | 55 · Aftercare only | $12.30 | $15.85 | $17.38 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $8.32 Median $10.47 Typical High $11.48 | Professional | 56 · Pre-op care only | $8.32 | $10.47 | $11.48 |
Aetna Setting Professional Modifier 78 · Unplanned return to OR Typical Low $57.54 Median $74.13 Typical High $81.28 | Professional | 78 · Unplanned return to OR | $57.54 | $74.13 | $81.28 |
Where Nevada sits
The same service costs 3.8 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
$120
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.