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 $154.88 Median $2,238.72 Typical High $5,011.87 | Facility | None | $154.88 | $2,238.72 | $5,011.87 |
Aetna Setting Professional Modifier None Typical Low $141.25 Median $186.21 Typical High $229.09 | Professional | None | $141.25 | $186.21 | $229.09 |
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 $144.54 Median $218.78 Typical High $338.84 | Professional | None | $144.54 | $218.78 | $338.84 |
Cigna Setting Facility Modifier None Typical Low $165.96 Median $208.93 Typical High $549.54 | Facility | None | $165.96 | $208.93 | $549.54 |
Cigna Setting Professional Modifier None Typical Low $123.03 Median $165.96 Typical High $288.40 | Professional | None | $123.03 | $165.96 | $288.40 |
Hometown Health Setting Professional Modifier None Typical Low $100.00 Median $169.82 Typical High $288.40 | Professional | None | $100.00 | $169.82 | $288.40 |
Hometown Health Setting Facility Modifier None Typical Low $165.96 Median $165.96 Typical High $165.96 | Facility | None | $165.96 | $165.96 | $165.96 |
Hometown Health Setting Professional Modifier None Typical Low $1.32 Median $208.93 Typical High $338.84 | Professional | None | $1.32 | $208.93 | $338.84 |
Select Health Setting Facility Modifier None Typical Low $141.25 Median $229.09 Typical High $4,265.80 | Facility | None | $141.25 | $229.09 | $4,265.80 |
Select Health Setting Professional Modifier None Typical Low $112.20 Median $181.97 Typical High $281.84 | Professional | None | $112.20 | $181.97 | $281.84 |
United Setting Facility Modifier None Typical Low $302.00 Median $512.86 Typical High $2,137.96 | Facility | None | $302.00 | $512.86 | $2,137.96 |
United Setting Professional Modifier None Typical Low $114.82 Median $181.97 Typical High $295.12 | Professional | None | $114.82 | $181.97 | $295.12 |
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 $70.79 Median $97.72 Typical High $104.71 | Professional | 52 · Reduced service | $70.79 | $97.72 | $104.71 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $28.18 Median $39.81 Typical High $41.69 | Professional | 53 · Discontinued | $28.18 | $39.81 | $41.69 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $104.71 Median $147.91 Typical High $154.88 | Professional | 54 · Surgery only | $104.71 | $147.91 | $154.88 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $20.89 Median $29.51 Typical High $30.90 | Professional | 55 · Aftercare only | $20.89 | $29.51 | $30.90 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $14.13 Median $19.50 Typical High $20.89 | Professional | 56 · Pre-op care only | $14.13 | $19.50 | $20.89 |
Aetna Setting Professional Modifier 78 · Unplanned return to OR Typical Low $97.72 Median $138.04 Typical High $144.54 | Professional | 78 · Unplanned return to OR | $97.72 | $138.04 | $144.54 |
Where Nevada sits
The same service costs 3.5 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· 39th of 51
$204
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.