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 $234.42 Median $1,698.24 Typical High $4,365.16 | Facility | None | $234.42 | $1,698.24 | $4,365.16 |
Aetna Setting Professional Modifier None Typical Low $213.80 Median $245.47 Typical High $269.15 | Professional | None | $213.80 | $245.47 | $269.15 |
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 $223.87 Median $257.04 Typical High $407.38 | Professional | None | $223.87 | $257.04 | $407.38 |
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 $190.55 Median $239.88 Typical High $380.19 | Professional | None | $190.55 | $239.88 | $380.19 |
Hometown Health Setting Professional Modifier None Typical Low $154.88 Median $251.19 Typical High $380.19 | Professional | None | $154.88 | $251.19 | $380.19 |
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 $1.70 Median $213.80 Typical High $407.38 | Professional | None | $1.70 | $213.80 | $407.38 |
Select Health Setting Facility Modifier None Typical Low $223.87 Median $275.42 Typical High $4,265.80 | Facility | None | $223.87 | $275.42 | $4,265.80 |
Select Health Setting Professional Modifier None Typical Low $177.83 Median $251.19 Typical High $446.68 | Professional | None | $177.83 | $251.19 | $446.68 |
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 $199.53 Median $257.04 Typical High $407.38 | Professional | None | $199.53 | $257.04 | $407.38 |
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 $107.15 Median $123.03 Typical High $131.83 | Professional | 52 · Reduced service | $107.15 | $123.03 | $131.83 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $42.66 Median $48.98 Typical High $52.48 | Professional | 53 · Discontinued | $42.66 | $48.98 | $52.48 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $162.18 Median $181.97 Typical High $194.98 | Professional | 54 · Surgery only | $162.18 | $181.97 | $194.98 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $32.36 Median $36.31 Typical High $38.90 | Professional | 55 · Aftercare only | $32.36 | $36.31 | $38.90 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $21.38 Median $24.55 Typical High $26.30 | Professional | 56 · Pre-op care only | $21.38 | $24.55 | $26.30 |
Aetna Setting Professional Modifier 78 · Unplanned return to OR Typical Low $151.36 Median $169.82 Typical High $181.97 | Professional | 78 · Unplanned return to OR | $151.36 | $169.82 | $181.97 |
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· 41st of 51
$251
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.