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 $316.23 Median $1,698.24 Typical High $4,365.16 | Facility | None | $316.23 | $1,698.24 | $4,365.16 |
Aetna Setting Professional Modifier None Typical Low $295.12 Median $316.23 Typical High $346.74 | Professional | None | $295.12 | $316.23 | $346.74 |
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 $302.00 Median $346.74 Typical High $562.34 | Professional | None | $302.00 | $346.74 | $562.34 |
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 $245.47 Median $269.15 Typical High $467.74 | Professional | None | $245.47 | $269.15 | $467.74 |
Hometown Health Setting Professional Modifier None Typical Low $208.93 Median $331.13 Typical High $524.81 | Professional | None | $208.93 | $331.13 | $524.81 |
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 $1.74 Median $213.80 Typical High $549.54 | Professional | None | $1.74 | $213.80 | $549.54 |
Select Health Setting Facility Modifier None Typical Low $309.03 Median $363.08 Typical High $4,265.80 | Facility | None | $309.03 | $363.08 | $4,265.80 |
Select Health Setting Professional Modifier None Typical Low $245.47 Median $331.13 Typical High $616.60 | Professional | None | $245.47 | $331.13 | $616.60 |
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 $218.78 Median $309.03 Typical High $501.19 | Professional | None | $218.78 | $309.03 | $501.19 |
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 $147.91 Median $158.49 Typical High $165.96 | Professional | 52 · Reduced service | $147.91 | $158.49 | $165.96 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $58.88 Median $63.10 Typical High $66.07 | Professional | 53 · Discontinued | $58.88 | $63.10 | $66.07 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $218.78 Median $234.42 Typical High $251.19 | Professional | 54 · Surgery only | $218.78 | $234.42 | $251.19 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $43.65 Median $47.86 Typical High $50.12 | Professional | 55 · Aftercare only | $43.65 | $47.86 | $50.12 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $29.51 Median $31.62 Typical High $33.11 | Professional | 56 · Pre-op care only | $29.51 | $31.62 | $33.11 |
Aetna Setting Professional Modifier 78 · Unplanned return to OR Typical Low $204.17 Median $218.78 Typical High $234.42 | Professional | 78 · Unplanned return to OR | $204.17 | $218.78 | $234.42 |
Where Nevada sits
The same service costs 5.8 times more in Alaska than in Utah. 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· 43rd of 51
$316
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.