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 $2,238.72 Typical High $5,011.87 | Facility | None | $323.59 | $2,238.72 | $5,011.87 |
Aetna Setting Professional Modifier None Typical Low $295.12 Median $436.52 Typical High $478.63 | Professional | None | $295.12 | $436.52 | $478.63 |
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 $302.00 Median $346.74 Typical High $562.34 | Professional | None | $302.00 | $346.74 | $562.34 |
Cigna Setting Facility Modifier None Typical Low $501.19 Median $812.83 Typical High $1,122.02 | Facility | None | $501.19 | $812.83 | $1,122.02 |
Cigna Setting Professional Modifier None Typical Low $263.03 Median $389.05 Typical High $616.60 | Professional | None | $263.03 | $389.05 | $616.60 |
Hometown Health Setting Professional Modifier None Typical Low $213.80 Median $389.05 Typical High $794.33 | Professional | None | $213.80 | $389.05 | $794.33 |
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 $2.14 Median $436.52 Typical High $1,174.90 | Professional | None | $2.14 | $436.52 | $1,174.90 |
Select Health Setting Facility Modifier None Typical Low $288.40 Median $457.09 Typical High $4,265.80 | Facility | None | $288.40 | $457.09 | $4,265.80 |
Select Health Setting Professional Modifier None Typical Low $234.42 Median $363.08 Typical High $537.03 | Professional | None | $234.42 | $363.08 | $537.03 |
United Setting Facility Modifier None Typical Low $467.74 Median $724.44 Typical High $2,884.03 | Facility | None | $467.74 | $724.44 | $2,884.03 |
United Setting Professional Modifier None Typical Low $251.19 Median $416.87 Typical High $630.96 | Professional | None | $251.19 | $416.87 | $630.96 |
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 $204.17 Typical High $239.88 | Professional | 52 · Reduced service | $147.91 | $204.17 | $239.88 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $58.88 Median $83.18 Typical High $95.50 | Professional | 53 · Discontinued | $58.88 | $83.18 | $95.50 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $218.78 Median $309.03 Typical High $354.81 | Professional | 54 · Surgery only | $218.78 | $309.03 | $354.81 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $43.65 Median $61.66 Typical High $70.79 | Professional | 55 · Aftercare only | $43.65 | $61.66 | $70.79 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $29.51 Median $41.69 Typical High $47.86 | Professional | 56 · Pre-op care only | $29.51 | $41.69 | $47.86 |
Aetna Setting Professional Modifier 78 · Unplanned return to OR Typical Low $204.17 Median $288.40 Typical High $331.13 | Professional | 78 · Unplanned return to OR | $204.17 | $288.40 | $331.13 |
Where Nevada sits
The same service costs 4.9 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· 42nd of 51
$417
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.