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 $275.42 Median $2,137.96 Typical High $10,715.19 | Facility | None | $275.42 | $2,137.96 | $10,715.19 |
Aetna Setting Professional Modifier None Typical Low $275.42 Median $288.40 Typical High $323.59 | Professional | None | $275.42 | $288.40 | $323.59 |
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 $288.40 Median $331.13 Typical High $537.03 | Professional | None | $288.40 | $331.13 | $537.03 |
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 $173.78 Median $239.88 Typical High $446.68 | Professional | None | $173.78 | $239.88 | $446.68 |
Hometown Health Setting Professional Modifier None Typical Low $194.98 Median $302.00 Typical High $501.19 | Professional | None | $194.98 | $302.00 | $501.19 |
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 $1.02 Median $213.80 Typical High $512.86 | Professional | None | $1.02 | $213.80 | $512.86 |
Select Health Setting Facility Modifier None Typical Low $295.12 Median $338.84 Typical High $4,265.80 | Facility | None | $295.12 | $338.84 | $4,265.80 |
Select Health Setting Professional Modifier None Typical Low $239.88 Median $316.23 Typical High $588.84 | Professional | None | $239.88 | $316.23 | $588.84 |
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 $169.82 Median $275.42 Typical High $457.09 | Professional | None | $169.82 | $275.42 | $457.09 |
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 $138.04 Median $144.54 Typical High $158.49 | Professional | 52 · Reduced service | $138.04 | $144.54 | $158.49 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $54.95 Median $58.88 Typical High $63.10 | Professional | 53 · Discontinued | $54.95 | $58.88 | $63.10 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $208.93 Median $218.78 Typical High $234.42 | Professional | 54 · Surgery only | $208.93 | $218.78 | $234.42 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $41.69 Median $43.65 Typical High $46.77 | Professional | 55 · Aftercare only | $41.69 | $43.65 | $46.77 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $27.54 Median $28.84 Typical High $31.62 | Professional | 56 · Pre-op care only | $27.54 | $28.84 | $31.62 |
Aetna Setting Professional Modifier 78 · Unplanned return to OR Typical Low $194.98 Median $204.17 Typical High $218.78 | Professional | 78 · Unplanned return to OR | $194.98 | $204.17 | $218.78 |
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· 42nd of 51
$288
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.