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 $302.00 Median $2,570.40 Typical High $5,011.87 | Facility | None | $302.00 | $2,570.40 | $5,011.87 |
Aetna Setting Professional Modifier None Typical Low $302.00 Median $478.63 Typical High $691.83 | Professional | None | $302.00 | $478.63 | $691.83 |
Anthem BCBS Setting Facility Modifier None Typical Low $2,754.23 Median $4,466.84 Typical High $5,754.40 | Facility | None | $2,754.23 | $4,466.84 | $5,754.40 |
Anthem BCBS Setting Professional Modifier None Typical Low $281.84 Median $457.09 Typical High $977.24 | Professional | None | $281.84 | $457.09 | $977.24 |
Cigna Setting Facility Modifier None Typical Low $234.42 Median $288.40 Typical High $741.31 | Facility | None | $234.42 | $288.40 | $741.31 |
Cigna Setting Professional Modifier None Typical Low $380.19 Median $501.19 Typical High $724.44 | Professional | None | $380.19 | $501.19 | $724.44 |
Hometown Health Setting Professional Modifier None Typical Low $288.40 Median $467.74 Typical High $724.44 | Professional | None | $288.40 | $467.74 | $724.44 |
Hometown Health Setting Facility Modifier None Typical Low $234.42 Median $234.42 Typical High $234.42 | Facility | None | $234.42 | $234.42 | $234.42 |
Hometown Health Setting Professional Modifier None Typical Low $2.57 Median $346.74 Typical High $616.60 | Professional | None | $2.57 | $346.74 | $616.60 |
Select Health Setting Facility Modifier None Typical Low $239.88 Median $407.38 Typical High $4,265.80 | Facility | None | $239.88 | $407.38 | $4,265.80 |
United Setting Facility Modifier None Typical Low $1,174.90 Median $1,698.24 Typical High $4,073.80 | Facility | None | $1,174.90 | $1,698.24 | $4,073.80 |
United Setting Professional Modifier None Typical Low $288.40 Median $457.09 Typical High $724.44 | Professional | None | $288.40 | $457.09 | $724.44 |
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 $151.36 Median $223.87 Typical High $239.88 | Professional | 52 · Reduced service | $151.36 | $223.87 | $239.88 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $60.26 Median $89.13 Typical High $95.50 | Professional | 53 · Discontinued | $60.26 | $89.13 | $95.50 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $223.87 Median $331.13 Typical High $363.08 | Professional | 54 · Surgery only | $223.87 | $331.13 | $363.08 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $44.67 Median $67.61 Typical High $72.44 | Professional | 55 · Aftercare only | $44.67 | $67.61 | $72.44 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $30.20 Median $44.67 Typical High $47.86 | Professional | 56 · Pre-op care only | $30.20 | $44.67 | $47.86 |
Aetna Setting Professional Modifier 78 · Unplanned return to OR Typical Low $208.93 Median $309.03 Typical High $338.84 | Professional | 78 · Unplanned return to OR | $208.93 | $309.03 | $338.84 |
Where Nevada sits
The same service costs 4.1 times more in Wisconsin than in Texas. 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· 35th of 51
$525
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.