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 $380.19 Median $2,570.40 Typical High $5,011.87 | Facility | None | $380.19 | $2,570.40 | $5,011.87 |
Aetna Setting Professional Modifier None Typical Low $371.54 Median $1,659.59 Typical High $1,995.26 | Professional | None | $371.54 | $1,659.59 | $1,995.26 |
Anthem BCBS Setting Facility Modifier None Typical Low $3,235.94 Median $6,760.83 Typical High $12,589.25 | Facility | None | $3,235.94 | $6,760.83 | $12,589.25 |
Anthem BCBS Setting Professional Modifier None Typical Low $346.74 Median $1,096.48 Typical High $2,570.40 | Professional | None | $346.74 | $1,096.48 | $2,570.40 |
Cigna Setting Facility Modifier None Typical Low $616.60 Median $1,778.28 Typical High $2,454.71 | Facility | None | $616.60 | $1,778.28 | $2,454.71 |
Cigna Setting Professional Modifier None Typical Low $257.04 Median $1,000.00 Typical High $2,290.87 | Professional | None | $257.04 | $1,000.00 | $2,290.87 |
Hometown Health Setting Professional Modifier None Typical Low $309.03 Median $1,380.38 Typical High $2,691.53 | Professional | None | $309.03 | $1,380.38 | $2,691.53 |
Hometown Health Setting Facility Modifier None Typical Low $1,698.24 Median $1,698.24 Typical High $1,698.24 | Facility | None | $1,698.24 | $1,698.24 | $1,698.24 |
Hometown Health Setting Professional Modifier None Typical Low $1.82 Median $467.74 Typical High $2,570.40 | Professional | None | $1.82 | $467.74 | $2,570.40 |
Select Health Setting Facility Modifier None Typical Low $309.03 Median $1,584.89 Typical High $4,265.80 | Facility | None | $309.03 | $1,584.89 | $4,265.80 |
United Setting Facility Modifier None Typical Low $1,174.90 Median $1,698.24 Typical High $4,677.35 | Facility | None | $1,174.90 | $1,698.24 | $4,677.35 |
United Setting Professional Modifier None Typical Low $346.74 Median $1,348.96 Typical High $2,511.89 | Professional | None | $346.74 | $1,348.96 | $2,511.89 |
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 $186.21 Median $208.93 Typical High $831.76 | Professional | 52 · Reduced service | $186.21 | $208.93 | $831.76 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $74.13 Median $85.11 Typical High $338.84 | Professional | 53 · Discontinued | $74.13 | $85.11 | $338.84 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $281.84 Median $316.23 Typical High $1,258.93 | Professional | 54 · Surgery only | $281.84 | $316.23 | $1,258.93 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $56.23 Median $63.10 Typical High $251.19 | Professional | 55 · Aftercare only | $56.23 | $63.10 | $251.19 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $37.15 Median $42.66 Typical High $169.82 | Professional | 56 · Pre-op care only | $37.15 | $42.66 | $169.82 |
Aetna Setting Professional Modifier 78 · Unplanned return to OR Typical Low $263.03 Median $295.12 Typical High $1,174.90 | Professional | 78 · Unplanned return to OR | $263.03 | $295.12 | $1,174.90 |
Where Nevada sits
The same service costs 5.8 times more in Alaska than in Nebraska. 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· 18th of 51
$1,622
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.