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 $169.82 Median $1,698.24 Typical High $4,365.16 | Facility | None | $169.82 | $1,698.24 | $4,365.16 |
Aetna Setting Professional Modifier None Typical Low $154.88 Median $245.47 Typical High $275.42 | Professional | None | $154.88 | $245.47 | $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 $162.18 Median $186.21 Typical High $295.12 | Professional | None | $162.18 | $186.21 | $295.12 |
Cigna Setting Facility Modifier None Typical Low $190.55 Median $239.88 Typical High $512.86 | Facility | None | $190.55 | $239.88 | $512.86 |
Cigna Setting Professional Modifier None Typical Low $141.25 Median $218.78 Typical High $338.84 | Professional | None | $141.25 | $218.78 | $338.84 |
Hometown Health Setting Professional Modifier None Typical Low $117.49 Median $190.55 Typical High $338.84 | Professional | None | $117.49 | $190.55 | $338.84 |
Hometown Health Setting Facility Modifier None Typical Low $190.55 Median $190.55 Typical High $190.55 | Facility | None | $190.55 | $190.55 | $190.55 |
Hometown Health Setting Professional Modifier None Typical Low $0.95 Median $218.78 Typical High $389.05 | Professional | None | $0.95 | $218.78 | $389.05 |
Select Health Setting Facility Modifier None Typical Low $147.91 Median $263.03 Typical High $4,265.80 | Facility | None | $147.91 | $263.03 | $4,265.80 |
Select Health Setting Professional Modifier None Typical Low $117.49 Median $208.93 Typical High $295.12 | Professional | None | $117.49 | $208.93 | $295.12 |
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 $213.80 Typical High $354.81 | Professional | None | $123.03 | $213.80 | $354.81 |
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 $77.62 Median $117.49 Typical High $128.82 | Professional | 52 · Reduced service | $77.62 | $117.49 | $128.82 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $30.90 Median $46.77 Typical High $52.48 | Professional | 53 · Discontinued | $30.90 | $46.77 | $52.48 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $117.49 Median $173.78 Typical High $194.98 | Professional | 54 · Surgery only | $117.49 | $173.78 | $194.98 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $23.44 Median $34.67 Typical High $38.90 | Professional | 55 · Aftercare only | $23.44 | $34.67 | $38.90 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $15.49 Median $23.44 Typical High $26.30 | Professional | 56 · Pre-op care only | $15.49 | $23.44 | $26.30 |
Aetna Setting Professional Modifier 78 · Unplanned return to OR Typical Low $109.65 Median $162.18 Typical High $181.97 | Professional | 78 · Unplanned return to OR | $109.65 | $162.18 | $181.97 |
Where Nevada sits
The same service costs 3.7 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· 45th 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.