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 $208.93 Median $1,698.24 Typical High $4,365.16 | Facility | None | $208.93 | $1,698.24 | $4,365.16 |
Aetna Setting Professional Modifier None Typical Low $194.98 Median $208.93 Typical High $263.03 | Professional | None | $194.98 | $208.93 | $263.03 |
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 $204.17 Median $234.42 Typical High $380.19 | Professional | None | $204.17 | $234.42 | $380.19 |
Cigna Setting Facility Modifier None Typical Low $134.90 Median $154.88 Typical High $245.47 | Facility | None | $134.90 | $154.88 | $245.47 |
Cigna Setting Professional Modifier None Typical Low $158.49 Median $186.21 Typical High $323.59 | Professional | None | $158.49 | $186.21 | $323.59 |
Hometown Health Setting Professional Modifier None Typical Low $144.54 Median $229.09 Typical High $354.81 | Professional | None | $144.54 | $229.09 | $354.81 |
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 $1.45 Median $213.80 Typical High $354.81 | Professional | None | $1.45 | $213.80 | $354.81 |
Select Health Setting Facility Modifier None Typical Low $208.93 Median $234.42 Typical High $4,265.80 | Facility | None | $208.93 | $234.42 | $4,265.80 |
Select Health Setting Professional Modifier None Typical Low $165.96 Median $223.87 Typical High $380.19 | Professional | None | $165.96 | $223.87 | $380.19 |
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 $147.91 Median $208.93 Typical High $331.13 | Professional | None | $147.91 | $208.93 | $331.13 |
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 $97.72 Median $104.71 Typical High $112.20 | Professional | 52 · Reduced service | $97.72 | $104.71 | $112.20 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $38.90 Median $41.69 Typical High $44.67 | Professional | 53 · Discontinued | $38.90 | $41.69 | $44.67 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $147.91 Median $154.88 Typical High $165.96 | Professional | 54 · Surgery only | $147.91 | $154.88 | $165.96 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $29.51 Median $31.62 Typical High $33.11 | Professional | 55 · Aftercare only | $29.51 | $31.62 | $33.11 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $19.50 Median $20.89 Typical High $22.39 | Professional | 56 · Pre-op care only | $19.50 | $20.89 | $22.39 |
Aetna Setting Professional Modifier 78 · Unplanned return to OR Typical Low $138.04 Median $144.54 Typical High $154.88 | Professional | 78 · Unplanned return to OR | $138.04 | $144.54 | $154.88 |
Where Nevada sits
The same service costs 5.1 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
$214
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.