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 $363.08 Median $2,238.72 Typical High $10,715.19 | Facility | None | $363.08 | $2,238.72 | $10,715.19 |
Aetna Setting Professional Modifier None Typical Low $234.42 Median $363.08 Typical High $398.11 | Professional | None | $234.42 | $363.08 | $398.11 |
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 $245.47 Median $281.84 Typical High $457.09 | Professional | None | $245.47 | $281.84 | $457.09 |
Cigna Setting Facility Modifier None Typical Low $251.19 Median $309.03 Typical High $912.01 | Facility | None | $251.19 | $309.03 | $912.01 |
Cigna Setting Professional Modifier None Typical Low $208.93 Median $323.59 Typical High $501.19 | Professional | None | $208.93 | $323.59 | $501.19 |
Hometown Health Setting Professional Modifier None Typical Low $173.78 Median $288.40 Typical High $489.78 | Professional | None | $173.78 | $288.40 | $489.78 |
Hometown Health Setting Facility Modifier None Typical Low $251.19 Median $251.19 Typical High $251.19 | Facility | None | $251.19 | $251.19 | $251.19 |
Hometown Health Setting Professional Modifier None Typical Low $1.12 Median $354.81 Typical High $562.34 | Professional | None | $1.12 | $354.81 | $562.34 |
Select Health Setting Facility Modifier None Typical Low $239.88 Median $371.54 Typical High $4,265.80 | Facility | None | $239.88 | $371.54 | $4,265.80 |
Select Health Setting Professional Modifier None Typical Low $190.55 Median $302.00 Typical High $446.68 | Professional | None | $190.55 | $302.00 | $446.68 |
United Setting Facility Modifier None Typical Low $954.99 Median $1,318.26 Typical High $3,311.31 | Facility | None | $954.99 | $1,318.26 | $3,311.31 |
United Setting Professional Modifier None Typical Low $208.93 Median $338.84 Typical High $524.81 | Professional | None | $208.93 | $338.84 | $524.81 |
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 $117.49 Median $169.82 Typical High $199.53 | Professional | 52 · Reduced service | $117.49 | $169.82 | $199.53 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $46.77 Median $69.18 Typical High $79.43 | Professional | 53 · Discontinued | $46.77 | $69.18 | $79.43 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $177.83 Median $257.04 Typical High $295.12 | Professional | 54 · Surgery only | $177.83 | $257.04 | $295.12 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $35.48 Median $51.29 Typical High $58.88 | Professional | 55 · Aftercare only | $35.48 | $51.29 | $58.88 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $23.44 Median $34.67 Typical High $39.81 | Professional | 56 · Pre-op care only | $23.44 | $34.67 | $39.81 |
Aetna Setting Professional Modifier 78 · Unplanned return to OR Typical Low $165.96 Median $239.88 Typical High $275.42 | Professional | 78 · Unplanned return to OR | $165.96 | $239.88 | $275.42 |
Where Nevada sits
The same service costs 4.3 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· 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.