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 $107.15 Median $2,137.96 Typical High $10,715.19 | Facility | None | $107.15 | $2,137.96 | $10,715.19 |
Aetna Setting Professional Modifier None Typical Low $107.15 Median $158.49 Typical High $165.96 | Professional | None | $107.15 | $158.49 | $165.96 |
Anthem BCBS Setting Facility Modifier None Typical Low $2,570.40 Median $3,801.89 Typical High $5,128.61 | Facility | None | $2,570.40 | $3,801.89 | $5,128.61 |
Anthem BCBS Setting Professional Modifier None Typical Low $102.33 Median $123.03 Typical High $208.93 | Professional | None | $102.33 | $123.03 | $208.93 |
Cigna Setting Facility Modifier None Typical Low $120.23 Median $147.91 Typical High $549.54 | Facility | None | $120.23 | $147.91 | $549.54 |
Cigna Setting Professional Modifier None Typical Low $85.11 Median $128.82 Typical High $208.93 | Professional | None | $85.11 | $128.82 | $208.93 |
Hometown Health Setting Professional Modifier None Typical Low $95.50 Median $151.36 Typical High $234.42 | Professional | None | $95.50 | $151.36 | $234.42 |
Hometown Health Setting Facility Modifier None Typical Low $120.23 Median $120.23 Typical High $120.23 | Facility | None | $120.23 | $120.23 | $120.23 |
Hometown Health Setting Professional Modifier None Typical Low $0.83 Median $144.54 Typical High $234.42 | Professional | None | $0.83 | $144.54 | $234.42 |
Select Health Setting Facility Modifier None Typical Low $95.50 Median $154.88 Typical High $4,265.80 | Facility | None | $95.50 | $154.88 | $4,265.80 |
Select Health Setting Professional Modifier None Typical Low $138.04 Median $138.04 Typical High $138.04 | Professional | None | $138.04 | $138.04 | $138.04 |
United Setting Facility Modifier None Typical Low $467.74 Median $724.44 Typical High $2,884.03 | Facility | None | $467.74 | $724.44 | $2,884.03 |
United Setting Professional Modifier None Typical Low $81.28 Median $147.91 Typical High $213.80 | Professional | None | $81.28 | $147.91 | $213.80 |
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 $53.70 Median $75.86 Typical High $83.18 | Professional | 52 · Reduced service | $53.70 | $75.86 | $83.18 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $21.38 Median $30.90 Typical High $33.11 | Professional | 53 · Discontinued | $21.38 | $30.90 | $33.11 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $81.28 Median $114.82 Typical High $125.89 | Professional | 54 · Surgery only | $81.28 | $114.82 | $125.89 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $16.22 Median $22.91 Typical High $25.12 | Professional | 55 · Aftercare only | $16.22 | $22.91 | $25.12 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $10.72 Median $15.14 Typical High $16.60 | Professional | 56 · Pre-op care only | $10.72 | $15.14 | $16.60 |
Aetna Setting Professional Modifier 78 · Unplanned return to OR Typical Low $75.86 Median $107.15 Typical High $117.49 | Professional | 78 · Unplanned return to OR | $75.86 | $107.15 | $117.49 |
Where Nevada sits
The same service costs 4.4 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· 43rd of 51
$151
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.