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 $114.82 Median $2,137.96 Typical High $10,715.19 | Facility | None | $114.82 | $2,137.96 | $10,715.19 |
Aetna Setting Professional Modifier None Typical Low $114.82 Median $194.98 Typical High $194.98 | Professional | None | $114.82 | $194.98 | $194.98 |
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 $109.65 Median $186.21 Typical High $316.23 | Professional | None | $109.65 | $186.21 | $316.23 |
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 $114.82 Median $186.21 Typical High $275.42 | Professional | None | $114.82 | $186.21 | $275.42 |
Hometown Health Setting Professional Modifier None Typical Low $114.82 Median $194.98 Typical High $331.13 | Professional | None | $114.82 | $194.98 | $331.13 |
Hometown Health Setting Professional Modifier None Typical Low $0.60 Median $173.78 Typical High $309.03 | Professional | None | $0.60 | $173.78 | $309.03 |
Select Health Setting Facility Modifier None Typical Low $114.82 Median $208.93 Typical High $4,265.80 | Facility | None | $114.82 | $208.93 | $4,265.80 |
Select Health Setting Professional Modifier None Typical Low $186.21 Median $186.21 Typical High $186.21 | Professional | None | $186.21 | $186.21 | $186.21 |
United Setting Facility Modifier None Typical Low $467.74 Median $776.25 Typical High $2,884.03 | Facility | None | $467.74 | $776.25 | $2,884.03 |
United Setting Professional Modifier None Typical Low $112.20 Median $190.55 Typical High $281.84 | Professional | None | $112.20 | $190.55 | $281.84 |
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 $89.13 Typical High $97.72 | Professional | 52 · Reduced service | $57.54 | $89.13 | $97.72 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $23.44 Median $35.48 Typical High $38.90 | Professional | 53 · Discontinued | $23.44 | $35.48 | $38.90 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $87.10 Median $131.83 Typical High $147.91 | Professional | 54 · Surgery only | $87.10 | $131.83 | $147.91 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $17.38 Median $26.30 Typical High $29.51 | Professional | 55 · Aftercare only | $17.38 | $26.30 | $29.51 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $11.48 Median $17.78 Typical High $19.50 | Professional | 56 · Pre-op care only | $11.48 | $17.78 | $19.50 |
Aetna Setting Professional Modifier 78 · Unplanned return to OR Typical Low $81.28 Median $123.03 Typical High $138.04 | Professional | 78 · Unplanned return to OR | $81.28 | $123.03 | $138.04 |
Where Nevada sits
The same service costs 3.8 times more in Wisconsin than in Hawaii. 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· 39th 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.