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 $1,698.24 Typical High $4,365.16 | Facility | None | $204.17 | $1,698.24 | $4,365.16 |
Aetna Setting Professional Modifier None Typical Low $204.17 Median $281.84 Typical High $346.74 | Professional | None | $204.17 | $281.84 | $346.74 |
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 $194.98 Median $281.84 Typical High $524.81 | Professional | None | $194.98 | $281.84 | $524.81 |
Cigna Setting Facility Modifier None Typical Low $398.11 Median $707.95 Typical High $1,000.00 | Facility | None | $398.11 | $707.95 | $1,000.00 |
Cigna Setting Professional Modifier None Typical Low $199.53 Median $263.03 Typical High $398.11 | Professional | None | $199.53 | $263.03 | $398.11 |
Hometown Health Setting Professional Modifier None Typical Low $213.80 Median $316.23 Typical High $831.76 | Professional | None | $213.80 | $316.23 | $831.76 |
Hometown Health Setting Facility Modifier None Typical Low $691.83 Median $691.83 Typical High $691.83 | Facility | None | $691.83 | $691.83 | $691.83 |
Hometown Health Setting Professional Modifier None Typical Low $1.20 Median $281.84 Typical High $1,023.29 | Professional | None | $1.20 | $281.84 | $1,023.29 |
Select Health Setting Facility Modifier None Typical Low $186.21 Median $275.42 Typical High $4,265.80 | Facility | None | $186.21 | $275.42 | $4,265.80 |
Select Health Setting Professional Modifier None Typical Low $245.47 Median $245.47 Typical High $245.47 | Professional | None | $245.47 | $245.47 | $245.47 |
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 $190.55 Median $281.84 Typical High $426.58 | Professional | None | $190.55 | $281.84 | $426.58 |
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 $141.25 Typical High $141.25 | Professional | 52 · Reduced service | $102.33 | $141.25 | $141.25 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $40.74 Median $56.23 Typical High $56.23 | Professional | 53 · Discontinued | $40.74 | $56.23 | $56.23 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $154.88 Median $208.93 Typical High $208.93 | Professional | 54 · Surgery only | $154.88 | $208.93 | $208.93 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $30.90 Median $41.69 Typical High $41.69 | Professional | 55 · Aftercare only | $30.90 | $41.69 | $41.69 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $20.42 Median $28.18 Typical High $28.18 | Professional | 56 · Pre-op care only | $20.42 | $28.18 | $28.18 |
Aetna Setting Professional Modifier 78 · Unplanned return to OR Typical Low $144.54 Median $194.98 Typical High $194.98 | Professional | 78 · Unplanned return to OR | $144.54 | $194.98 | $194.98 |
Where Nevada sits
The same service costs 4.3 times more in Alaska 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· 42nd 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.