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 $154.88 Median $1,698.24 Typical High $4,365.16 | Facility | None | $154.88 | $1,698.24 | $4,365.16 |
Aetna Setting Professional Modifier None Typical Low $141.25 Median $169.82 Typical High $186.21 | Professional | None | $141.25 | $169.82 | $186.21 |
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 $147.91 Median $169.82 Typical High $269.15 | Professional | None | $147.91 | $169.82 | $269.15 |
Cigna Setting Facility Modifier None Typical Low $134.90 Median $154.88 Typical High $239.88 | Facility | None | $134.90 | $154.88 | $239.88 |
Cigna Setting Professional Modifier None Typical Low $123.03 Median $147.91 Typical High $251.19 | Professional | None | $123.03 | $147.91 | $251.19 |
Hometown Health Setting Professional Modifier None Typical Low $104.71 Median $169.82 Typical High $263.03 | Professional | None | $104.71 | $169.82 | $263.03 |
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 $0.78 Median $213.80 Typical High $295.12 | Professional | None | $0.78 | $213.80 | $295.12 |
Select Health Setting Facility Modifier None Typical Low $154.88 Median $194.98 Typical High $4,265.80 | Facility | None | $154.88 | $194.98 | $4,265.80 |
Select Health Setting Professional Modifier None Typical Low $123.03 Median $173.78 Typical High $309.03 | Professional | None | $123.03 | $173.78 | $309.03 |
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 $117.49 Median $169.82 Typical High $257.04 | Professional | None | $117.49 | $169.82 | $257.04 |
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 $70.79 Median $85.11 Typical High $91.20 | Professional | 52 · Reduced service | $70.79 | $85.11 | $91.20 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $28.18 Median $33.88 Typical High $36.31 | Professional | 53 · Discontinued | $28.18 | $33.88 | $36.31 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $107.15 Median $125.89 Typical High $134.90 | Professional | 54 · Surgery only | $107.15 | $125.89 | $134.90 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $21.38 Median $25.70 Typical High $27.54 | Professional | 55 · Aftercare only | $21.38 | $25.70 | $27.54 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $14.13 Median $16.98 Typical High $18.62 | Professional | 56 · Pre-op care only | $14.13 | $16.98 | $18.62 |
Aetna Setting Professional Modifier 78 · Unplanned return to OR Typical Low $100.00 Median $117.49 Typical High $125.89 | Professional | 78 · Unplanned return to OR | $100.00 | $117.49 | $125.89 |
Where Nevada sits
The same service costs 4.6 times more in Alaska than in Florida. 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
$170
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.