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 $239.88 Typical High $275.42 | Professional | None | $147.91 | $239.88 | $275.42 |
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 $151.36 Median $177.83 Typical High $288.40 | Professional | None | $151.36 | $177.83 | $288.40 |
Cigna Setting Facility Modifier None Typical Low $194.98 Median $245.47 Typical High $512.86 | Facility | None | $194.98 | $245.47 | $512.86 |
Cigna Setting Professional Modifier None Typical Low $125.89 Median $213.80 Typical High $323.59 | Professional | None | $125.89 | $213.80 | $323.59 |
Hometown Health Setting Professional Modifier None Typical Low $112.20 Median $190.55 Typical High $338.84 | Professional | None | $112.20 | $190.55 | $338.84 |
Hometown Health Setting Facility Modifier None Typical Low $194.98 Median $194.98 Typical High $194.98 | Facility | None | $194.98 | $194.98 | $194.98 |
Hometown Health Setting Professional Modifier None Typical Low $0.60 Median $208.93 Typical High $398.11 | Professional | None | $0.60 | $208.93 | $398.11 |
Select Health Setting Facility Modifier None Typical Low $141.25 Median $263.03 Typical High $4,265.80 | Facility | None | $141.25 | $263.03 | $4,265.80 |
Select Health Setting Professional Modifier None Typical Low $112.20 Median $208.93 Typical High $281.84 | Professional | None | $112.20 | $208.93 | $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 $107.15 Median $213.80 Typical High $338.84 | Professional | None | $107.15 | $213.80 | $338.84 |
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 $114.82 Typical High $131.83 | Professional | 52 · Reduced service | $74.13 | $114.82 | $131.83 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $29.51 Median $45.71 Typical High $52.48 | Professional | 53 · Discontinued | $29.51 | $45.71 | $52.48 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $112.20 Median $169.82 Typical High $194.98 | Professional | 54 · Surgery only | $112.20 | $169.82 | $194.98 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $22.39 Median $33.88 Typical High $38.90 | Professional | 55 · Aftercare only | $22.39 | $33.88 | $38.90 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $14.79 Median $22.91 Typical High $26.30 | Professional | 56 · Pre-op care only | $14.79 | $22.91 | $26.30 |
Aetna Setting Professional Modifier 78 · Unplanned return to OR Typical Low $104.71 Median $158.49 Typical High $181.97 | Professional | 78 · Unplanned return to OR | $104.71 | $158.49 | $181.97 |
Where Nevada sits
The same service costs 4.4 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· 43rd 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.