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 $281.84 Median $1,698.24 Typical High $4,365.16 | Facility | None | $281.84 | $1,698.24 | $4,365.16 |
Aetna Setting Professional Modifier None Typical Low $257.04 Median $338.84 Typical High $398.11 | Professional | None | $257.04 | $338.84 | $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 $269.15 Median $309.03 Typical High $501.19 | Professional | None | $269.15 | $309.03 | $501.19 |
Cigna Setting Facility Modifier None Typical Low $281.84 Median $354.81 Typical High $912.01 | Facility | None | $281.84 | $354.81 | $912.01 |
Cigna Setting Professional Modifier None Typical Low $213.80 Median $323.59 Typical High $524.81 | Professional | None | $213.80 | $323.59 | $524.81 |
Hometown Health Setting Professional Modifier None Typical Low $204.17 Median $331.13 Typical High $501.19 | Professional | None | $204.17 | $331.13 | $501.19 |
Hometown Health Setting Facility Modifier None Typical Low $281.84 Median $281.84 Typical High $281.84 | Facility | None | $281.84 | $281.84 | $281.84 |
Hometown Health Setting Professional Modifier None Typical Low $4.07 Median $380.19 Typical High $575.44 | Professional | None | $4.07 | $380.19 | $575.44 |
Select Health Setting Facility Modifier None Typical Low $251.19 Median $389.05 Typical High $4,265.80 | Facility | None | $251.19 | $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 $954.99 Median $1,318.26 Typical High $3,311.31 | Facility | None | $954.99 | $1,318.26 | $3,311.31 |
United Setting Professional Modifier None Typical Low $223.87 Median $346.74 Typical High $524.81 | Professional | None | $223.87 | $346.74 | $524.81 |
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 $128.82 Median $173.78 Typical High $199.53 | Professional | 52 · Reduced service | $128.82 | $173.78 | $199.53 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $51.29 Median $69.18 Typical High $79.43 | Professional | 53 · Discontinued | $51.29 | $69.18 | $79.43 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $190.55 Median $257.04 Typical High $302.00 | Professional | 54 · Surgery only | $190.55 | $257.04 | $302.00 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $38.02 Median $51.29 Typical High $60.26 | Professional | 55 · Aftercare only | $38.02 | $51.29 | $60.26 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $25.70 Median $34.67 Typical High $39.81 | Professional | 56 · Pre-op care only | $25.70 | $34.67 | $39.81 |
Aetna Setting Professional Modifier 78 · Unplanned return to OR Typical Low $177.83 Median $239.88 Typical High $281.84 | Professional | 78 · Unplanned return to OR | $177.83 | $239.88 | $281.84 |
Where Nevada sits
The same service costs 4.8 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
$339
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.