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 $234.42 Median $1,698.24 Typical High $4,365.16 | Facility | None | $234.42 | $1,698.24 | $4,365.16 |
Aetna Setting Professional Modifier None Typical Low $229.09 Median $234.42 Typical High $257.04 | Professional | None | $229.09 | $234.42 | $257.04 |
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 $239.88 Median $275.42 Typical High $436.52 | Professional | None | $239.88 | $275.42 | $436.52 |
Cigna Setting Facility Modifier None Typical Low $398.11 Median $912.01 Typical High $1,318.26 | Facility | None | $398.11 | $912.01 | $1,318.26 |
Cigna Setting Professional Modifier None Typical Low $165.96 Median $190.55 Typical High $363.08 | Professional | None | $165.96 | $190.55 | $363.08 |
Hometown Health Setting Professional Modifier None Typical Low $162.18 Median $257.04 Typical High $501.19 | Professional | None | $162.18 | $257.04 | $501.19 |
Hometown Health Setting Facility Modifier None Typical Low $912.01 Median $912.01 Typical High $912.01 | Facility | None | $912.01 | $912.01 | $912.01 |
Hometown Health Setting Professional Modifier None Typical Low $1.55 Median $363.08 Typical High $1,380.38 | Professional | None | $1.55 | $363.08 | $1,380.38 |
Select Health Setting Facility Modifier None Typical Low $245.47 Median $269.15 Typical High $4,265.80 | Facility | None | $245.47 | $269.15 | $4,265.80 |
Select Health Setting Professional Modifier None Typical Low $194.98 Median $263.03 Typical High $489.78 | Professional | None | $194.98 | $263.03 | $489.78 |
United Setting Facility Modifier None Typical Low $467.74 Median $776.25 Typical High $2,884.03 | Facility | None | $467.74 | $776.25 | $2,884.03 |
United Setting Professional Modifier None Typical Low $173.78 Median $234.42 Typical High $363.08 | Professional | None | $173.78 | $234.42 | $363.08 |
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 $114.82 Median $117.49 Typical High $128.82 | Professional | 52 · Reduced service | $114.82 | $117.49 | $128.82 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $45.71 Median $46.77 Typical High $51.29 | Professional | 53 · Discontinued | $45.71 | $46.77 | $51.29 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $173.78 Median $173.78 Typical High $190.55 | Professional | 54 · Surgery only | $173.78 | $173.78 | $190.55 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $34.67 Median $34.67 Typical High $38.02 | Professional | 55 · Aftercare only | $34.67 | $34.67 | $38.02 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $22.91 Median $23.44 Typical High $25.70 | Professional | 56 · Pre-op care only | $22.91 | $23.44 | $25.70 |
Aetna Setting Professional Modifier 78 · Unplanned return to OR Typical Low $162.18 Median $162.18 Typical High $177.83 | Professional | 78 · Unplanned return to OR | $162.18 | $162.18 | $177.83 |
Where Nevada sits
The same service costs 5.4 times more in Alaska than in Utah. 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
$251
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.