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 $120.23 Median $1,698.24 Typical High $4,365.16 | Facility | None | $120.23 | $1,698.24 | $4,365.16 |
Aetna Setting Professional Modifier None Typical Low $114.82 Median $177.83 Typical High $204.17 | Professional | None | $114.82 | $177.83 | $204.17 |
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 $107.15 Median $128.82 Typical High $223.87 | Professional | None | $107.15 | $128.82 | $223.87 |
Cigna Setting Facility Modifier None Typical Low $128.82 Median $147.91 Typical High $234.42 | Facility | None | $128.82 | $147.91 | $234.42 |
Cigna Setting Professional Modifier None Typical Low $89.13 Median $154.88 Typical High $257.04 | Professional | None | $89.13 | $154.88 | $257.04 |
Hometown Health Setting Professional Modifier None Typical Low $102.33 Median $169.82 Typical High $281.84 | Professional | None | $102.33 | $169.82 | $281.84 |
Hometown Health Setting Facility Modifier None Typical Low $134.90 Median $134.90 Typical High $134.90 | Facility | None | $134.90 | $134.90 | $134.90 |
Hometown Health Setting Professional Modifier None Typical Low $0.78 Median $151.36 Typical High $281.84 | Professional | None | $0.78 | $151.36 | $281.84 |
Select Health Setting Facility Modifier None Typical Low $102.33 Median $186.21 Typical High $4,265.80 | Facility | None | $102.33 | $186.21 | $4,265.80 |
Select Health Setting Professional Modifier None Typical Low $169.82 Median $169.82 Typical High $169.82 | Professional | None | $169.82 | $169.82 | $169.82 |
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 $89.13 Median $173.78 Typical High $257.04 | Professional | None | $89.13 | $173.78 | $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 $57.54 Median $87.10 Typical High $102.33 | Professional | 52 · Reduced service | $57.54 | $87.10 | $102.33 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $22.91 Median $34.67 Typical High $40.74 | Professional | 53 · Discontinued | $22.91 | $34.67 | $40.74 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $85.11 Median $128.82 Typical High $151.36 | Professional | 54 · Surgery only | $85.11 | $128.82 | $151.36 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $16.98 Median $25.70 Typical High $30.20 | Professional | 55 · Aftercare only | $16.98 | $25.70 | $30.20 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $11.48 Median $17.38 Typical High $20.42 | Professional | 56 · Pre-op care only | $11.48 | $17.38 | $20.42 |
Aetna Setting Professional Modifier 78 · Unplanned return to OR Typical Low $79.43 Median $120.23 Typical High $141.25 | Professional | 78 · Unplanned return to OR | $79.43 | $120.23 | $141.25 |
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· 41st 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.