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 $128.82 Median $2,137.96 Typical High $10,715.19 | Facility | None | $128.82 | $2,137.96 | $10,715.19 |
Aetna Setting Professional Modifier None Typical Low $128.82 Median $218.78 Typical High $263.03 | Professional | None | $128.82 | $218.78 | $263.03 |
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 $123.03 Median $147.91 Typical High $223.87 | Professional | None | $123.03 | $147.91 | $223.87 |
Cigna Setting Facility Modifier None Typical Low $54.95 Median $741.31 Typical High $2,137.96 | Facility | None | $54.95 | $741.31 | $2,137.96 |
Cigna Setting Professional Modifier None Typical Low $107.15 Median $186.21 Typical High $281.84 | Professional | None | $107.15 | $186.21 | $281.84 |
Hometown Health Setting Professional Modifier None Typical Low $117.49 Median $194.98 Typical High $346.74 | Professional | None | $117.49 | $194.98 | $346.74 |
Hometown Health Setting Professional Modifier None Typical Low $0.78 Median $173.78 Typical High $316.23 | Professional | None | $0.78 | $173.78 | $316.23 |
Select Health Setting Facility Modifier None Typical Low $114.82 Median $213.80 Typical High $4,265.80 | Facility | None | $114.82 | $213.80 | $4,265.80 |
Select Health Setting Professional Modifier None Typical Low $190.55 Median $190.55 Typical High $190.55 | Professional | None | $190.55 | $190.55 | $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 $102.33 Median $190.55 Typical High $288.40 | Professional | None | $102.33 | $190.55 | $288.40 |
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 $64.57 Median $95.50 Typical High $117.49 | Professional | 52 · Reduced service | $64.57 | $95.50 | $117.49 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $25.70 Median $38.02 Typical High $46.77 | Professional | 53 · Discontinued | $25.70 | $38.02 | $46.77 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $97.72 Median $144.54 Typical High $173.78 | Professional | 54 · Surgery only | $97.72 | $144.54 | $173.78 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $19.50 Median $28.84 Typical High $34.67 | Professional | 55 · Aftercare only | $19.50 | $28.84 | $34.67 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $12.88 Median $19.05 Typical High $23.44 | Professional | 56 · Pre-op care only | $12.88 | $19.05 | $23.44 |
Aetna Setting Professional Modifier 78 · Unplanned return to OR Typical Low $91.20 Median $134.90 Typical High $162.18 | Professional | 78 · Unplanned return to OR | $91.20 | $134.90 | $162.18 |
Where Nevada sits
The same service costs 4.5 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· 36th of 51
$195
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.