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 $346.74 Median $1,698.24 Typical High $4,365.16 | Facility | None | $346.74 | $1,698.24 | $4,365.16 |
Aetna Setting Professional Modifier None Typical Low $309.03 Median $331.13 Typical High $426.58 | Professional | None | $309.03 | $331.13 | $426.58 |
Ambetter Setting Professional Modifier None Typical Low $309.03 Median $363.08 Typical High $363.08 | Professional | None | $309.03 | $363.08 | $363.08 |
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 $323.59 Median $371.54 Typical High $602.56 | Professional | None | $323.59 | $371.54 | $602.56 |
Cigna Setting Facility Modifier None Typical Low $134.90 Median $154.88 Typical High $245.47 | Facility | None | $134.90 | $154.88 | $245.47 |
Cigna Setting Professional Modifier None Typical Low $218.78 Median $263.03 Typical High $501.19 | Professional | None | $218.78 | $263.03 | $501.19 |
Hometown Health Setting Professional Modifier None Typical Low $218.78 Median $338.84 Typical High $562.34 | Professional | None | $218.78 | $338.84 | $562.34 |
Hometown Health Setting Facility Modifier None Typical Low $141.25 Median $141.25 Typical High $141.25 | Facility | None | $141.25 | $141.25 | $141.25 |
Hometown Health Setting Professional Modifier None Typical Low $2.00 Median $213.80 Typical High $575.44 | Professional | None | $2.00 | $213.80 | $575.44 |
Select Health Setting Facility Modifier None Typical Low $338.84 Median $380.19 Typical High $4,265.80 | Facility | None | $338.84 | $380.19 | $4,265.80 |
Select Health Setting Professional Modifier None Typical Low $269.15 Median $354.81 Typical High $676.08 | Professional | None | $269.15 | $354.81 | $676.08 |
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 $208.93 Median $302.00 Typical High $512.86 | Professional | None | $208.93 | $302.00 | $512.86 |
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 $158.49 Median $162.18 Typical High $177.83 | Professional | 52 · Reduced service | $158.49 | $162.18 | $177.83 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $63.10 Median $66.07 Typical High $70.79 | Professional | 53 · Discontinued | $63.10 | $66.07 | $70.79 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $234.42 Median $245.47 Typical High $269.15 | Professional | 54 · Surgery only | $234.42 | $245.47 | $269.15 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $46.77 Median $48.98 Typical High $53.70 | Professional | 55 · Aftercare only | $46.77 | $48.98 | $53.70 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $31.62 Median $33.11 Typical High $35.48 | Professional | 56 · Pre-op care only | $31.62 | $33.11 | $35.48 |
Aetna Setting Professional Modifier 78 · Unplanned return to OR Typical Low $218.78 Median $229.09 Typical High $251.19 | Professional | 78 · Unplanned return to OR | $218.78 | $229.09 | $251.19 |
Where Nevada sits
The same service costs 5.6 times more in Alaska than in Texas. 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· 41st of 51
$331
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.