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 $173.78 Median $1,698.24 Typical High $4,365.16 | Facility | None | $173.78 | $1,698.24 | $4,365.16 |
Aetna Setting Professional Modifier None Typical Low $173.78 Median $275.42 Typical High $309.03 | Professional | None | $173.78 | $275.42 | $309.03 |
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 $165.96 Median $263.03 Typical High $436.52 | Professional | None | $165.96 | $263.03 | $436.52 |
Cigna Setting Facility Modifier None Typical Low $213.80 Median $269.15 Typical High $512.86 | Facility | None | $213.80 | $269.15 | $512.86 |
Cigna Setting Professional Modifier None Typical Low $147.91 Median $229.09 Typical High $346.74 | Professional | None | $147.91 | $229.09 | $346.74 |
Hometown Health Setting Professional Modifier None Typical Low $162.18 Median $257.04 Typical High $380.19 | Professional | None | $162.18 | $257.04 | $380.19 |
Hometown Health Setting Facility Modifier None Typical Low $213.80 Median $213.80 Typical High $213.80 | Facility | None | $213.80 | $213.80 | $213.80 |
Hometown Health Setting Professional Modifier None Typical Low $0.42 Median $229.09 Typical High $380.19 | Professional | None | $0.42 | $229.09 | $380.19 |
Select Health Setting Facility Modifier None Typical Low $151.36 Median $251.19 Typical High $4,265.80 | Facility | None | $151.36 | $251.19 | $4,265.80 |
Select Health Setting Professional Modifier None Typical Low $223.87 Median $223.87 Typical High $223.87 | Professional | None | $223.87 | $223.87 | $223.87 |
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 $147.91 Median $251.19 Typical High $371.54 | Professional | None | $147.91 | $251.19 | $371.54 |
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 $87.10 Median $131.83 Typical High $138.04 | Professional | 52 · Reduced service | $87.10 | $131.83 | $138.04 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $34.67 Median $52.48 Typical High $54.95 | Professional | 53 · Discontinued | $34.67 | $52.48 | $54.95 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $131.83 Median $199.53 Typical High $204.17 | Professional | 54 · Surgery only | $131.83 | $199.53 | $204.17 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $26.30 Median $39.81 Typical High $41.69 | Professional | 55 · Aftercare only | $26.30 | $39.81 | $41.69 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $17.38 Median $26.30 Typical High $27.54 | Professional | 56 · Pre-op care only | $17.38 | $26.30 | $27.54 |
Aetna Setting Professional Modifier 78 · Unplanned return to OR Typical Low $123.03 Median $186.21 Typical High $190.55 | Professional | 78 · Unplanned return to OR | $123.03 | $186.21 | $190.55 |
Where Nevada sits
The same service costs 4.3 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· 36th of 51
$275
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.