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 $125.89 Median $1,698.24 Typical High $4,365.16 | Facility | None | $125.89 | $1,698.24 | $4,365.16 |
Aetna Setting Professional Modifier None Typical Low $125.89 Median $204.17 Typical High $239.88 | Professional | None | $125.89 | $204.17 | $239.88 |
Anthem BCBS Setting Facility Modifier None Typical Low $2,570.40 Median $3,801.89 Typical High $5,128.61 | Facility | None | $2,570.40 | $3,801.89 | $5,128.61 |
Anthem BCBS Setting Professional Modifier None Typical Low $120.23 Median $218.78 Typical High $363.08 | Professional | None | $120.23 | $218.78 | $363.08 |
Cigna Setting Facility Modifier None Typical Low $173.78 Median $218.78 Typical High $912.01 | Facility | None | $173.78 | $218.78 | $912.01 |
Cigna Setting Professional Modifier None Typical Low $109.65 Median $177.83 Typical High $281.84 | Professional | None | $109.65 | $177.83 | $281.84 |
Hometown Health Setting Professional Modifier None Typical Low $120.23 Median $199.53 Typical High $323.59 | Professional | None | $120.23 | $199.53 | $323.59 |
Hometown Health Setting Facility Modifier None Typical Low $173.78 Median $173.78 Typical High $173.78 | Facility | None | $173.78 | $173.78 | $173.78 |
Hometown Health Setting Professional Modifier None Typical Low $0.48 Median $169.82 Typical High $323.59 | Professional | None | $0.48 | $169.82 | $323.59 |
Select Health Setting Facility Modifier None Typical Low $114.82 Median $213.80 Typical High $4,265.80 | Facility | None | $114.82 | $213.80 | $4,265.80 |
Select Health Setting Professional Modifier None Typical Low $194.98 Median $194.98 Typical High $194.98 | Professional | None | $194.98 | $194.98 | $194.98 |
United Setting Facility Modifier None Typical Low $467.74 Median $724.44 Typical High $2,884.03 | Facility | None | $467.74 | $724.44 | $2,884.03 |
United Setting Professional Modifier None Typical Low $112.20 Median $204.17 Typical High $302.00 | Professional | None | $112.20 | $204.17 | $302.00 |
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 $63.10 Median $95.50 Typical High $114.82 | Professional | 52 · Reduced service | $63.10 | $95.50 | $114.82 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $25.70 Median $38.90 Typical High $45.71 | Professional | 53 · Discontinued | $25.70 | $38.90 | $45.71 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $95.50 Median $144.54 Typical High $169.82 | Professional | 54 · Surgery only | $95.50 | $144.54 | $169.82 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $19.05 Median $28.84 Typical High $33.88 | Professional | 55 · Aftercare only | $19.05 | $28.84 | $33.88 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $12.59 Median $19.50 Typical High $22.91 | Professional | 56 · Pre-op care only | $12.59 | $19.50 | $22.91 |
Aetna Setting Professional Modifier 78 · Unplanned return to OR Typical Low $89.13 Median $134.90 Typical High $158.49 | Professional | 78 · Unplanned return to OR | $89.13 | $134.90 | $158.49 |
Where Nevada sits
The same service costs 3.8 times more in Wisconsin 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· 35th of 51
$219
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.