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 $501.19 Median $1,698.24 Typical High $4,365.16 | Facility | None | $501.19 | $1,698.24 | $4,365.16 |
Aetna Setting Professional Modifier None Typical Low $467.74 Median $501.19 Typical High $549.54 | Professional | None | $467.74 | $501.19 | $549.54 |
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 $478.63 Median $562.34 Typical High $891.25 | Professional | None | $478.63 | $562.34 | $891.25 |
Cigna Setting Facility Modifier None Typical Low $141.25 Median $177.83 Typical High $489.78 | Facility | None | $141.25 | $177.83 | $489.78 |
Cigna Setting Professional Modifier None Typical Low $398.11 Median $416.87 Typical High $758.58 | Professional | None | $398.11 | $416.87 | $758.58 |
Hometown Health Setting Professional Modifier None Typical Low $257.04 Median $512.86 Typical High $812.83 | Professional | None | $257.04 | $512.86 | $812.83 |
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 $4.17 Median $213.80 Typical High $851.14 | Professional | None | $4.17 | $213.80 | $851.14 |
Select Health Setting Facility Modifier None Typical Low $467.74 Median $562.34 Typical High $4,265.80 | Facility | None | $467.74 | $562.34 | $4,265.80 |
Select Health Setting Professional Modifier None Typical Low $380.19 Median $524.81 Typical High $954.99 | Professional | None | $380.19 | $524.81 | $954.99 |
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 $380.19 Median $501.19 Typical High $776.25 | Professional | None | $380.19 | $501.19 | $776.25 |
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 $234.42 Median $251.19 Typical High $263.03 | Professional | 52 · Reduced service | $234.42 | $251.19 | $263.03 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $93.33 Median $100.00 Typical High $107.15 | Professional | 53 · Discontinued | $93.33 | $100.00 | $107.15 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $354.81 Median $380.19 Typical High $398.11 | Professional | 54 · Surgery only | $354.81 | $380.19 | $398.11 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $70.79 Median $75.86 Typical High $79.43 | Professional | 55 · Aftercare only | $70.79 | $75.86 | $79.43 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $46.77 Median $50.12 Typical High $53.70 | Professional | 56 · Pre-op care only | $46.77 | $50.12 | $53.70 |
Aetna Setting Professional Modifier 78 · Unplanned return to OR Typical Low $331.13 Median $354.81 Typical High $371.54 | Professional | 78 · Unplanned return to OR | $331.13 | $354.81 | $371.54 |
Where Nevada sits
The same service costs 5.8 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
$501
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.