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 $181.97 Median $1,698.24 Typical High $4,365.16 | Facility | None | $181.97 | $1,698.24 | $4,365.16 |
Aetna Setting Professional Modifier None Typical Low $165.96 Median $257.04 Typical High $288.40 | Professional | None | $165.96 | $257.04 | $288.40 |
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 $169.82 Median $194.98 Typical High $316.23 | Professional | None | $169.82 | $194.98 | $316.23 |
Cigna Setting Facility Modifier None Typical Low $398.11 Median $776.25 Typical High $1,122.02 | Facility | None | $398.11 | $776.25 | $1,122.02 |
Cigna Setting Professional Modifier None Typical Low $151.36 Median $229.09 Typical High $354.81 | Professional | None | $151.36 | $229.09 | $354.81 |
Hometown Health Setting Professional Modifier None Typical Low $123.03 Median $223.87 Typical High $512.86 | Professional | None | $123.03 | $223.87 | $512.86 |
Hometown Health Setting Facility Modifier None Typical Low $776.25 Median $776.25 Typical High $776.25 | Facility | None | $776.25 | $776.25 | $776.25 |
Hometown Health Setting Professional Modifier None Typical Low $0.95 Median $234.42 Typical High $1,174.90 | Professional | None | $0.95 | $234.42 | $1,174.90 |
Select Health Setting Facility Modifier None Typical Low $154.88 Median $275.42 Typical High $4,265.80 | Facility | None | $154.88 | $275.42 | $4,265.80 |
Select Health Setting Professional Modifier None Typical Low $125.89 Median $218.78 Typical High $316.23 | Professional | None | $125.89 | $218.78 | $316.23 |
United Setting Facility Modifier None Typical Low $302.00 Median $512.86 Typical High $2,137.96 | Facility | None | $302.00 | $512.86 | $2,137.96 |
United Setting Professional Modifier None Typical Low $120.23 Median $234.42 Typical High $371.54 | Professional | None | $120.23 | $234.42 | $371.54 |
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 $83.18 Median $123.03 Typical High $138.04 | Professional | 52 · Reduced service | $83.18 | $123.03 | $138.04 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $33.11 Median $48.98 Typical High $54.95 | Professional | 53 · Discontinued | $33.11 | $48.98 | $54.95 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $123.03 Median $186.21 Typical High $208.93 | Professional | 54 · Surgery only | $123.03 | $186.21 | $208.93 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $25.12 Median $37.15 Typical High $41.69 | Professional | 55 · Aftercare only | $25.12 | $37.15 | $41.69 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $16.60 Median $24.55 Typical High $27.54 | Professional | 56 · Pre-op care only | $16.60 | $24.55 | $27.54 |
Aetna Setting Professional Modifier 78 · Unplanned return to OR Typical Low $114.82 Median $173.78 Typical High $194.98 | Professional | 78 · Unplanned return to OR | $114.82 | $173.78 | $194.98 |
Where Nevada sits
The same service costs 4.1 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· 44th of 51
$234
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.