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 $204.17 Median $2,238.72 Typical High $5,011.87 | Facility | None | $204.17 | $2,238.72 | $5,011.87 |
Aetna Setting Professional Modifier None Typical Low $204.17 Median $302.00 Typical High $302.00 | Professional | None | $204.17 | $302.00 | $302.00 |
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 $194.98 Median $295.12 Typical High $478.63 | Professional | None | $194.98 | $295.12 | $478.63 |
Cigna Setting Facility Modifier None Typical Low $309.03 Median $389.05 Typical High $676.08 | Facility | None | $309.03 | $389.05 | $676.08 |
Cigna Setting Professional Modifier None Typical Low $186.21 Median $269.15 Typical High $398.11 | Professional | None | $186.21 | $269.15 | $398.11 |
Hometown Health Setting Professional Modifier None Typical Low $204.17 Median $309.03 Typical High $501.19 | Professional | None | $204.17 | $309.03 | $501.19 |
Hometown Health Setting Facility Modifier None Typical Low $309.03 Median $309.03 Typical High $309.03 | Facility | None | $309.03 | $309.03 | $309.03 |
Hometown Health Setting Professional Modifier None Typical Low $1.20 Median $281.84 Typical High $467.74 | Professional | None | $1.20 | $281.84 | $467.74 |
Select Health Setting Facility Modifier None Typical Low $186.21 Median $309.03 Typical High $4,265.80 | Facility | None | $186.21 | $309.03 | $4,265.80 |
Select Health Setting Professional Modifier None Typical Low $275.42 Median $275.42 Typical High $275.42 | Professional | None | $275.42 | $275.42 | $275.42 |
United Setting Facility Modifier None Typical Low $97.72 Median $234.42 Typical High $1,949.84 | Facility | None | $97.72 | $234.42 | $1,949.84 |
United Setting Professional Modifier None Typical Low $199.53 Median $302.00 Typical High $436.52 | Professional | None | $199.53 | $302.00 | $436.52 |
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 $102.33 Median $151.36 Typical High $151.36 | Professional | 52 · Reduced service | $102.33 | $151.36 | $151.36 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $40.74 Median $60.26 Typical High $60.26 | Professional | 53 · Discontinued | $40.74 | $60.26 | $60.26 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $151.36 Median $229.09 Typical High $229.09 | Professional | 54 · Surgery only | $151.36 | $229.09 | $229.09 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $30.90 Median $45.71 Typical High $45.71 | Professional | 55 · Aftercare only | $30.90 | $45.71 | $45.71 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $20.42 Median $30.20 Typical High $30.20 | Professional | 56 · Pre-op care only | $20.42 | $30.20 | $30.20 |
Aetna Setting Professional Modifier 78 · Unplanned return to OR Typical Low $141.25 Median $213.80 Typical High $213.80 | Professional | 78 · Unplanned return to OR | $141.25 | $213.80 | $213.80 |
Where Nevada sits
The same service costs 3.7 times more in Wisconsin than in Utah. 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· 40th of 51
$302
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.