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 $323.59 Median $1,698.24 Typical High $4,365.16 | Facility | None | $323.59 | $1,698.24 | $4,365.16 |
Aetna Setting Professional Modifier None Typical Low $295.12 Median $323.59 Typical High $354.81 | Professional | None | $295.12 | $323.59 | $354.81 |
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 $309.03 Median $354.81 Typical High $575.44 | Professional | None | $309.03 | $354.81 | $575.44 |
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 $281.84 Typical High $489.78 | Professional | None | $245.47 | $281.84 | $489.78 |
Hometown Health Setting Professional Modifier None Typical Low $213.80 Median $338.84 Typical High $537.03 | Professional | None | $213.80 | $338.84 | $537.03 |
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 $1.62 Median $213.80 Typical High $562.34 | Professional | None | $1.62 | $213.80 | $562.34 |
Select Health Setting Facility Modifier None Typical Low $316.23 Median $371.54 Typical High $4,265.80 | Facility | None | $316.23 | $371.54 | $4,265.80 |
Select Health Setting Professional Modifier None Typical Low $251.19 Median $338.84 Typical High $630.96 | Professional | None | $251.19 | $338.84 | $630.96 |
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 $223.87 Median $323.59 Typical High $512.86 | Professional | None | $223.87 | $323.59 | $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 $147.91 Median $162.18 Typical High $169.82 | Professional | 52 · Reduced service | $147.91 | $162.18 | $169.82 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $58.88 Median $64.57 Typical High $67.61 | Professional | 53 · Discontinued | $58.88 | $64.57 | $67.61 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $223.87 Median $239.88 Typical High $251.19 | Professional | 54 · Surgery only | $223.87 | $239.88 | $251.19 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $44.67 Median $47.86 Typical High $51.29 | Professional | 55 · Aftercare only | $44.67 | $47.86 | $51.29 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $29.51 Median $32.36 Typical High $33.88 | Professional | 56 · Pre-op care only | $29.51 | $32.36 | $33.88 |
Aetna Setting Professional Modifier 78 · Unplanned return to OR Typical Low $208.93 Median $223.87 Typical High $234.42 | Professional | 78 · Unplanned return to OR | $208.93 | $223.87 | $234.42 |
Where Nevada sits
The same service costs 5.9 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· 44th of 51
$324
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.