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 $269.15 Median $1,698.24 Typical High $4,365.16 | Facility | None | $269.15 | $1,698.24 | $4,365.16 |
Aetna Setting Professional Modifier None Typical Low $245.47 Median $295.12 Typical High $398.11 | Professional | None | $245.47 | $295.12 | $398.11 |
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 $257.04 Median $295.12 Typical High $467.74 | Professional | None | $257.04 | $295.12 | $467.74 |
Cigna Setting Facility Modifier None Typical Low $281.84 Median $323.59 Typical High $741.31 | Facility | None | $281.84 | $323.59 | $741.31 |
Cigna Setting Professional Modifier None Typical Low $218.78 Median $295.12 Typical High $489.78 | Professional | None | $218.78 | $295.12 | $489.78 |
Hometown Health Setting Professional Modifier None Typical Low $177.83 Median $295.12 Typical High $512.86 | Professional | None | $177.83 | $295.12 | $512.86 |
Hometown Health Setting Facility Modifier None Typical Low $295.12 Median $295.12 Typical High $295.12 | Facility | None | $295.12 | $295.12 | $295.12 |
Hometown Health Setting Professional Modifier None Typical Low $2.40 Median $371.54 Typical High $588.84 | Professional | None | $2.40 | $371.54 | $588.84 |
Select Health Setting Facility Modifier None Typical Low $245.47 Median $389.05 Typical High $4,265.80 | Facility | None | $245.47 | $389.05 | $4,265.80 |
Select Health Setting Professional Modifier None Typical Low $199.53 Median $316.23 Typical High $501.19 | Professional | None | $199.53 | $316.23 | $501.19 |
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 $245.47 Median $331.13 Typical High $512.86 | Professional | None | $245.47 | $331.13 | $512.86 |
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 $123.03 Median $169.82 Typical High $177.83 | Professional | 52 · Reduced service | $123.03 | $169.82 | $177.83 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $48.98 Median $67.61 Typical High $72.44 | Professional | 53 · Discontinued | $48.98 | $67.61 | $72.44 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $186.21 Median $257.04 Typical High $275.42 | Professional | 54 · Surgery only | $186.21 | $257.04 | $275.42 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $37.15 Median $51.29 Typical High $53.70 | Professional | 55 · Aftercare only | $37.15 | $51.29 | $53.70 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $24.55 Median $33.88 Typical High $35.48 | Professional | 56 · Pre-op care only | $24.55 | $33.88 | $35.48 |
Aetna Setting Professional Modifier 78 · Unplanned return to OR Typical Low $173.78 Median $239.88 Typical High $251.19 | Professional | 78 · Unplanned return to OR | $173.78 | $239.88 | $251.19 |
Where Nevada sits
The same service costs 4.5 times more in Alaska than in Texas. 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· 43rd of 51
$324
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.