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 $91.20 Median $1,698.24 Typical High $4,365.16 | Facility | None | $91.20 | $1,698.24 | $4,365.16 |
Aetna Setting Professional Modifier None Typical Low $81.28 Median $114.82 Typical High $125.89 | Professional | None | $81.28 | $114.82 | $125.89 |
Anthem BCBS Setting Facility Modifier None Typical Low $2,570.40 Median $3,801.89 Typical High $5,128.61 | Facility | None | $2,570.40 | $3,801.89 | $5,128.61 |
Anthem BCBS Setting Professional Modifier None Typical Low $85.11 Median $125.89 Typical High $186.21 | Professional | None | $85.11 | $125.89 | $186.21 |
Cigna Setting Facility Modifier None Typical Low $81.28 Median $95.50 Typical High $147.91 | Facility | None | $81.28 | $95.50 | $147.91 |
Cigna Setting Professional Modifier None Typical Low $72.44 Median $100.00 Typical High $186.21 | Professional | None | $72.44 | $100.00 | $186.21 |
Hometown Health Setting Professional Modifier None Typical Low $57.54 Median $95.50 Typical High $162.18 | Professional | None | $57.54 | $95.50 | $162.18 |
Hometown Health Setting Facility Modifier None Typical Low $85.11 Median $85.11 Typical High $85.11 | Facility | None | $85.11 | $85.11 | $85.11 |
Hometown Health Setting Professional Modifier None Typical Low $0.30 Median $123.03 Typical High $190.55 | Professional | None | $0.30 | $123.03 | $190.55 |
Select Health Setting Facility Modifier None Typical Low $83.18 Median $128.82 Typical High $4,265.80 | Facility | None | $83.18 | $128.82 | $4,265.80 |
Select Health Setting Professional Modifier None Typical Low $66.07 Median $102.33 Typical High $165.96 | Professional | None | $66.07 | $102.33 | $165.96 |
United Setting Facility Modifier None Typical Low $467.74 Median $776.25 Typical High $2,884.03 | Facility | None | $467.74 | $776.25 | $2,884.03 |
United Setting Professional Modifier None Typical Low $58.88 Median $114.82 Typical High $181.97 | Professional | None | $58.88 | $114.82 | $181.97 |
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 $40.74 Median $51.29 Typical High $61.66 | Professional | 52 · Reduced service | $40.74 | $51.29 | $61.66 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $16.60 Median $20.89 Typical High $24.55 | Professional | 53 · Discontinued | $16.60 | $20.89 | $24.55 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $61.66 Median $77.62 Typical High $91.20 | Professional | 54 · Surgery only | $61.66 | $77.62 | $91.20 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $12.30 Median $15.49 Typical High $18.20 | Professional | 55 · Aftercare only | $12.30 | $15.49 | $18.20 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $8.13 Median $10.47 Typical High $12.30 | Professional | 56 · Pre-op care only | $8.13 | $10.47 | $12.30 |
Aetna Setting Professional Modifier 78 · Unplanned return to OR Typical Low $57.54 Median $72.44 Typical High $85.11 | Professional | 78 · Unplanned return to OR | $57.54 | $72.44 | $85.11 |
Where Nevada sits
The same service costs 4.0 times more in Alaska than in Florida. 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· 42nd of 51
$115
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.