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 $2,238.72 Typical High $5,011.87 | Facility | None | $114.82 | $2,238.72 | $5,011.87 |
Aetna Setting Professional Modifier None Typical Low $114.82 Median $165.96 Typical High $194.98 | Professional | None | $114.82 | $165.96 | $194.98 |
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 $107.15 Median $186.21 Typical High $269.15 | Professional | None | $107.15 | $186.21 | $269.15 |
Cigna Setting Facility Modifier None Typical Low $141.25 Median $177.83 Typical High $676.08 | Facility | None | $141.25 | $177.83 | $676.08 |
Cigna Setting Professional Modifier None Typical Low $95.50 Median $138.04 Typical High $218.78 | Professional | None | $95.50 | $138.04 | $218.78 |
Hometown Health Setting Professional Modifier None Typical Low $91.20 Median $141.25 Typical High $223.87 | Professional | None | $91.20 | $141.25 | $223.87 |
Hometown Health Setting Facility Modifier None Typical Low $141.25 Median $141.25 Typical High $141.25 | Facility | None | $141.25 | $141.25 | $141.25 |
Hometown Health Setting Professional Modifier None Typical Low $0.78 Median $147.91 Typical High $281.84 | Professional | None | $0.78 | $147.91 | $281.84 |
Select Health Setting Facility Modifier None Typical Low $100.00 Median $190.55 Typical High $4,265.80 | Facility | None | $100.00 | $190.55 | $4,265.80 |
Select Health Setting Professional Modifier None Typical Low $85.11 Median $117.49 Typical High $199.53 | Professional | None | $85.11 | $117.49 | $199.53 |
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 $91.20 Median $147.91 Typical High $223.87 | Professional | None | $91.20 | $147.91 | $223.87 |
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 $77.62 Typical High $97.72 | Professional | 52 · Reduced service | $57.54 | $77.62 | $97.72 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $22.91 Median $30.90 Typical High $39.81 | Professional | 53 · Discontinued | $22.91 | $30.90 | $39.81 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $85.11 Median $117.49 Typical High $147.91 | Professional | 54 · Surgery only | $85.11 | $117.49 | $147.91 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $17.38 Median $23.44 Typical High $29.51 | Professional | 55 · Aftercare only | $17.38 | $23.44 | $29.51 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $11.48 Median $15.49 Typical High $19.50 | Professional | 56 · Pre-op care only | $11.48 | $15.49 | $19.50 |
Aetna Setting Professional Modifier 78 · Unplanned return to OR Typical Low $79.43 Median $109.65 Typical High $138.04 | Professional | 78 · Unplanned return to OR | $79.43 | $109.65 | $138.04 |
Where Nevada sits
The same service costs 3.4 times more in Alaska than in Florida. 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· 44th of 51
$148
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.