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 $75.86 Median $616.60 Typical High $10,715.19 | Facility | None | $75.86 | $616.60 | $10,715.19 |
Aetna Setting Professional Modifier None Typical Low $75.86 Median $100.00 Typical High $117.49 | Professional | None | $75.86 | $100.00 | $117.49 |
Anthem BCBS Setting Facility Modifier None Typical Low $2,238.72 Median $3,548.13 Typical High $4,466.84 | Facility | None | $2,238.72 | $3,548.13 | $4,466.84 |
Anthem BCBS Setting Professional Modifier None Typical Low $79.43 Median $91.20 Typical High $147.91 | Professional | None | $79.43 | $91.20 | $147.91 |
Cigna Setting Facility Modifier None Typical Low $64.57 Median $81.28 Typical High $549.54 | Facility | None | $64.57 | $81.28 | $549.54 |
Cigna Setting Professional Modifier None Typical Low $77.62 Median $112.20 Typical High $173.78 | Professional | None | $77.62 | $112.20 | $173.78 |
Hometown Health Setting Professional Modifier None Typical Low $66.07 Median $100.00 Typical High $162.18 | Professional | None | $66.07 | $100.00 | $162.18 |
Hometown Health Setting Facility Modifier None Typical Low $64.57 Median $64.57 Typical High $64.57 | Facility | None | $64.57 | $64.57 | $64.57 |
Hometown Health Setting Professional Modifier None Typical Low $1.55 Median $97.72 Typical High $154.88 | Professional | None | $1.55 | $97.72 | $154.88 |
Select Health Setting Facility Modifier None Typical Low $70.79 Median $104.71 Typical High $4,265.80 | Facility | None | $70.79 | $104.71 | $4,265.80 |
Select Health Setting Professional Modifier None Typical Low $57.54 Median $91.20 Typical High $144.54 | Professional | None | $57.54 | $91.20 | $144.54 |
United Setting Facility Modifier None Typical Low $97.72 Median $245.47 Typical High $1,949.84 | Facility | None | $97.72 | $245.47 | $1,949.84 |
United Setting Professional Modifier None Typical Low $74.13 Median $102.33 Typical High $165.96 | Professional | None | $74.13 | $102.33 | $165.96 |
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 $38.02 Median $46.77 Typical High $54.95 | Professional | 52 · Reduced service | $38.02 | $46.77 | $54.95 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $15.14 Median $19.05 Typical High $21.88 | Professional | 53 · Discontinued | $15.14 | $19.05 | $21.88 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $57.54 Median $70.79 Typical High $81.28 | Professional | 54 · Surgery only | $57.54 | $70.79 | $81.28 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $11.48 Median $14.13 Typical High $16.22 | Professional | 55 · Aftercare only | $11.48 | $14.13 | $16.22 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $7.59 Median $9.33 Typical High $10.96 | Professional | 56 · Pre-op care only | $7.59 | $9.33 | $10.96 |
Aetna Setting Professional Modifier 78 · Unplanned return to OR Typical Low $53.70 Median $66.07 Typical High $75.86 | Professional | 78 · Unplanned return to OR | $53.70 | $66.07 | $75.86 |
Where Nevada sits
The same service costs 3.9 times more in Alaska than in Florida. 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· 42nd of 51
$100
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.