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 $134.90 Median $1,698.24 Typical High $4,365.16 | Facility | None | $134.90 | $1,698.24 | $4,365.16 |
Aetna Setting Professional Modifier None Typical Low $128.82 Median $218.78 Typical High $302.00 | Professional | None | $128.82 | $218.78 | $302.00 |
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 $120.23 Median $144.54 Typical High $251.19 | Professional | None | $120.23 | $144.54 | $251.19 |
Cigna Setting Facility Modifier None Typical Low $213.80 Median $245.47 Typical High $380.19 | Facility | None | $213.80 | $245.47 | $380.19 |
Cigna Setting Professional Modifier None Typical Low $102.33 Median $199.53 Typical High $331.13 | Professional | None | $102.33 | $199.53 | $331.13 |
Hometown Health Setting Professional Modifier None Typical Low $109.65 Median $223.87 Typical High $398.11 | Professional | None | $109.65 | $223.87 | $398.11 |
Hometown Health Setting Facility Modifier None Typical Low $223.87 Median $223.87 Typical High $223.87 | Facility | None | $223.87 | $223.87 | $223.87 |
Hometown Health Setting Professional Modifier None Typical Low $1.07 Median $165.96 Typical High $398.11 | Professional | None | $1.07 | $165.96 | $398.11 |
Select Health Setting Facility Modifier None Typical Low $109.65 Median $269.15 Typical High $4,265.80 | Facility | None | $109.65 | $269.15 | $4,265.80 |
Select Health Setting Professional Modifier None Typical Low $239.88 Median $239.88 Typical High $239.88 | Professional | None | $239.88 | $239.88 | $239.88 |
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 $112.20 Median $208.93 Typical High $363.08 | Professional | None | $112.20 | $208.93 | $363.08 |
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 $63.10 Median $107.15 Typical High $151.36 | Professional | 52 · Reduced service | $63.10 | $107.15 | $151.36 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $25.70 Median $42.66 Typical High $60.26 | Professional | 53 · Discontinued | $25.70 | $42.66 | $60.26 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $95.50 Median $162.18 Typical High $223.87 | Professional | 54 · Surgery only | $95.50 | $162.18 | $223.87 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $19.05 Median $32.36 Typical High $45.71 | Professional | 55 · Aftercare only | $19.05 | $32.36 | $45.71 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $12.88 Median $21.38 Typical High $30.20 | Professional | 56 · Pre-op care only | $12.88 | $21.38 | $30.20 |
Aetna Setting Professional Modifier 78 · Unplanned return to OR Typical Low $89.13 Median $151.36 Typical High $208.93 | Professional | 78 · Unplanned return to OR | $89.13 | $151.36 | $208.93 |
Where Nevada sits
The same service costs 3.9 times more in Alaska than in Kentucky. 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
$204
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.