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 $102.33 Median $1,698.24 Typical High $4,365.16 | Facility | None | $102.33 | $1,698.24 | $4,365.16 |
Aetna Setting Professional Modifier None Typical Low $93.33 Median $107.15 Typical High $117.49 | Professional | None | $93.33 | $107.15 | $117.49 |
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 $97.72 Median $112.20 Typical High $181.97 | Professional | None | $97.72 | $112.20 | $181.97 |
Cigna Setting Facility Modifier None Typical Low $83.18 Median $95.50 Typical High $151.36 | Facility | None | $83.18 | $95.50 | $151.36 |
Cigna Setting Professional Modifier None Typical Low $85.11 Median $107.15 Typical High $169.82 | Professional | None | $85.11 | $107.15 | $169.82 |
Hometown Health Setting Professional Modifier None Typical Low $70.79 Median $114.82 Typical High $177.83 | Professional | None | $70.79 | $114.82 | $177.83 |
Hometown Health Setting Facility Modifier None Typical Low $87.10 Median $87.10 Typical High $87.10 | Facility | None | $87.10 | $87.10 | $87.10 |
Hometown Health Setting Professional Modifier None Typical Low $1.32 Median $131.83 Typical High $186.21 | Professional | None | $1.32 | $131.83 | $186.21 |
Select Health Setting Facility Modifier None Typical Low $102.33 Median $123.03 Typical High $4,265.80 | Facility | None | $102.33 | $123.03 | $4,265.80 |
Select Health Setting Professional Modifier None Typical Low $81.28 Median $112.20 Typical High $190.55 | Professional | None | $81.28 | $112.20 | $190.55 |
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 $91.20 Median $112.20 Typical High $181.97 | Professional | None | $91.20 | $112.20 | $181.97 |
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 $46.77 Median $53.70 Typical High $58.88 | Professional | 52 · Reduced service | $46.77 | $53.70 | $58.88 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $18.62 Median $21.38 Typical High $23.44 | Professional | 53 · Discontinued | $18.62 | $21.38 | $23.44 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $69.18 Median $79.43 Typical High $89.13 | Professional | 54 · Surgery only | $69.18 | $79.43 | $89.13 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $13.80 Median $16.22 Typical High $17.78 | Professional | 55 · Aftercare only | $13.80 | $16.22 | $17.78 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $9.33 Median $10.72 Typical High $11.75 | Professional | 56 · Pre-op care only | $9.33 | $10.72 | $11.75 |
Aetna Setting Professional Modifier 78 · Unplanned return to OR Typical Low $64.57 Median $74.13 Typical High $83.18 | Professional | 78 · Unplanned return to OR | $64.57 | $74.13 | $83.18 |
Where Nevada sits
The same service costs 4.5 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· 44th of 51
$110
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.