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 $138.04 Median $2,238.72 Typical High $5,011.87 | Facility | None | $138.04 | $2,238.72 | $5,011.87 |
Aetna Setting Professional Modifier None Typical Low $125.89 Median $218.78 Typical High $251.19 | Professional | None | $125.89 | $218.78 | $251.19 |
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 $128.82 Median $147.91 Typical High $245.47 | Professional | None | $128.82 | $147.91 | $245.47 |
Cigna Setting Facility Modifier None Typical Low $173.78 Median $218.78 Typical High $549.54 | Facility | None | $173.78 | $218.78 | $549.54 |
Cigna Setting Professional Modifier None Typical Low $112.20 Median $199.53 Typical High $323.59 | Professional | None | $112.20 | $199.53 | $323.59 |
Hometown Health Setting Professional Modifier None Typical Low $91.20 Median $181.97 Typical High $309.03 | Professional | None | $91.20 | $181.97 | $309.03 |
Hometown Health Setting Facility Modifier None Typical Low $173.78 Median $173.78 Typical High $173.78 | Facility | None | $173.78 | $173.78 | $173.78 |
Hometown Health Setting Professional Modifier None Typical Low $1.02 Median $190.55 Typical High $354.81 | Professional | None | $1.02 | $190.55 | $354.81 |
Select Health Setting Facility Modifier None Typical Low $125.89 Median $239.88 Typical High $4,265.80 | Facility | None | $125.89 | $239.88 | $4,265.80 |
Select Health Setting Professional Modifier None Typical Low $102.33 Median $190.55 Typical High $239.88 | Professional | None | $102.33 | $190.55 | $239.88 |
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 $112.20 Median $204.17 Typical High $346.74 | Professional | None | $112.20 | $204.17 | $346.74 |
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 $63.10 Median $93.33 Typical High $125.89 | Professional | 52 · Reduced service | $63.10 | $93.33 | $125.89 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $25.12 Median $38.02 Typical High $50.12 | Professional | 53 · Discontinued | $25.12 | $38.02 | $50.12 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $93.33 Median $141.25 Typical High $190.55 | Professional | 54 · Surgery only | $93.33 | $141.25 | $190.55 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $18.62 Median $28.18 Typical High $38.02 | Professional | 55 · Aftercare only | $18.62 | $28.18 | $38.02 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $12.59 Median $19.05 Typical High $25.12 | Professional | 56 · Pre-op care only | $12.59 | $19.05 | $25.12 |
Aetna Setting Professional Modifier 78 · Unplanned return to OR Typical Low $87.10 Median $131.83 Typical High $177.83 | Professional | 78 · Unplanned return to OR | $87.10 | $131.83 | $177.83 |
Where Nevada sits
The same service costs 3.6 times more in Alaska than in Kentucky. 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
$200
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.