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 $162.18 Median $1,698.24 Typical High $4,365.16 | Facility | None | $162.18 | $1,698.24 | $4,365.16 |
Aetna Setting Professional Modifier None Typical Low $147.91 Median $229.09 Typical High $281.84 | Professional | None | $147.91 | $229.09 | $281.84 |
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 $154.88 Median $177.83 Typical High $288.40 | Professional | None | $154.88 | $177.83 | $288.40 |
Cigna Setting Facility Modifier None Typical Low $407.38 Median $812.83 Typical High $1,122.02 | Facility | None | $407.38 | $812.83 | $1,122.02 |
Cigna Setting Professional Modifier None Typical Low $125.89 Median $204.17 Typical High $338.84 | Professional | None | $125.89 | $204.17 | $338.84 |
Hometown Health Setting Professional Modifier None Typical Low $109.65 Median $208.93 Typical High $512.86 | Professional | None | $109.65 | $208.93 | $512.86 |
Hometown Health Setting Facility Modifier None Typical Low $776.25 Median $776.25 Typical High $776.25 | Facility | None | $776.25 | $776.25 | $776.25 |
Hometown Health Setting Professional Modifier None Typical Low $1.02 Median $213.80 Typical High $1,174.90 | Professional | None | $1.02 | $213.80 | $1,174.90 |
Select Health Setting Facility Modifier None Typical Low $141.25 Median $269.15 Typical High $4,265.80 | Facility | None | $141.25 | $269.15 | $4,265.80 |
Select Health Setting Professional Modifier None Typical Low $114.82 Median $218.78 Typical High $288.40 | Professional | None | $114.82 | $218.78 | $288.40 |
United Setting Facility Modifier None Typical Low $467.74 Median $724.44 Typical High $2,884.03 | Facility | None | $467.74 | $724.44 | $2,884.03 |
United Setting Professional Modifier None Typical Low $123.03 Median $218.78 Typical High $346.74 | Professional | None | $123.03 | $218.78 | $346.74 |
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 $74.13 Median $112.20 Typical High $134.90 | Professional | 52 · Reduced service | $74.13 | $112.20 | $134.90 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $29.51 Median $44.67 Typical High $53.70 | Professional | 53 · Discontinued | $29.51 | $44.67 | $53.70 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $112.20 Median $165.96 Typical High $199.53 | Professional | 54 · Surgery only | $112.20 | $165.96 | $199.53 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $22.39 Median $33.11 Typical High $39.81 | Professional | 55 · Aftercare only | $22.39 | $33.11 | $39.81 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $14.79 Median $22.39 Typical High $26.92 | Professional | 56 · Pre-op care only | $14.79 | $22.39 | $26.92 |
Aetna Setting Professional Modifier 78 · Unplanned return to OR Typical Low $104.71 Median $154.88 Typical High $186.21 | Professional | 78 · Unplanned return to OR | $104.71 | $154.88 | $186.21 |
Where Nevada sits
The same service costs 4.5 times more in Alaska than in Kentucky. 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· 44th of 51
$219
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.