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 $134.90 Median $1,698.24 Typical High $4,365.16 | Facility | None | $134.90 | $1,698.24 | $4,365.16 |
Aetna Setting Professional Modifier None Typical Low $134.90 Median $199.53 Typical High $239.88 | Professional | None | $134.90 | $199.53 | $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 $128.82 Median $229.09 Typical High $331.13 | Professional | None | $128.82 | $229.09 | $331.13 |
Cigna Setting Facility Modifier None Typical Low $177.83 Median $223.87 Typical High $512.86 | Facility | None | $177.83 | $223.87 | $512.86 |
Cigna Setting Professional Modifier None Typical Low $114.82 Median $162.18 Typical High $269.15 | Professional | None | $114.82 | $162.18 | $269.15 |
Hometown Health Setting Professional Modifier None Typical Low $109.65 Median $177.83 Typical High $275.42 | Professional | None | $109.65 | $177.83 | $275.42 |
Hometown Health Setting Facility Modifier None Typical Low $177.83 Median $177.83 Typical High $177.83 | Facility | None | $177.83 | $177.83 | $177.83 |
Hometown Health Setting Professional Modifier None Typical Low $0.54 Median $177.83 Typical High $338.84 | Professional | None | $0.54 | $177.83 | $338.84 |
Select Health Setting Facility Modifier None Typical Low $117.49 Median $223.87 Typical High $4,265.80 | Facility | None | $117.49 | $223.87 | $4,265.80 |
Select Health Setting Professional Modifier None Typical Low $100.00 Median $141.25 Typical High $234.42 | Professional | None | $100.00 | $141.25 | $234.42 |
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 $104.71 Median $181.97 Typical High $269.15 | Professional | None | $104.71 | $181.97 | $269.15 |
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 $67.61 Median $97.72 Typical High $120.23 | Professional | 52 · Reduced service | $67.61 | $97.72 | $120.23 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $26.92 Median $38.90 Typical High $47.86 | Professional | 53 · Discontinued | $26.92 | $38.90 | $47.86 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $102.33 Median $144.54 Typical High $181.97 | Professional | 54 · Surgery only | $102.33 | $144.54 | $181.97 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $20.42 Median $28.84 Typical High $36.31 | Professional | 55 · Aftercare only | $20.42 | $28.84 | $36.31 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $13.49 Median $19.50 Typical High $23.99 | Professional | 56 · Pre-op care only | $13.49 | $19.50 | $23.99 |
Aetna Setting Professional Modifier 78 · Unplanned return to OR Typical Low $95.50 Median $134.90 Typical High $169.82 | Professional | 78 · Unplanned return to OR | $95.50 | $134.90 | $169.82 |
Where Nevada sits
The same service costs 3.3 times more in Alaska than in Washington, DC. 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
$186
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.