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 $275.42 Median $2,238.72 Typical High $5,011.87 | Facility | None | $275.42 | $2,238.72 | $5,011.87 |
Aetna Setting Professional Modifier None Typical Low $275.42 Median $331.13 Typical High $380.19 | Professional | None | $275.42 | $331.13 | $380.19 |
Ambetter Setting Professional Modifier None Typical Low $331.13 Median $331.13 Typical High $331.13 | Professional | None | $331.13 | $331.13 | $331.13 |
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 $263.03 Median $363.08 Typical High $575.44 | Professional | None | $263.03 | $363.08 | $575.44 |
Cigna Setting Facility Modifier None Typical Low $501.19 Median $1,548.82 Typical High $2,238.72 | Facility | None | $501.19 | $1,548.82 | $2,238.72 |
Cigna Setting Professional Modifier None Typical Low $213.80 Median $309.03 Typical High $446.68 | Professional | None | $213.80 | $309.03 | $446.68 |
Hometown Health Setting Professional Modifier None Typical Low $229.09 Median $323.59 Typical High $645.65 | Professional | None | $229.09 | $323.59 | $645.65 |
Hometown Health Setting Facility Modifier None Typical Low $1,548.82 Median $1,548.82 Typical High $1,548.82 | Facility | None | $1,548.82 | $1,548.82 | $1,548.82 |
Hometown Health Setting Professional Modifier None Typical Low $1.07 Median $363.08 Typical High $2,344.23 | Professional | None | $1.07 | $363.08 | $2,344.23 |
Select Health Setting Facility Modifier None Typical Low $239.88 Median $363.08 Typical High $4,265.80 | Facility | None | $239.88 | $363.08 | $4,265.80 |
Select Health Setting Professional Modifier None Typical Low $204.17 Median $229.09 Typical High $489.78 | Professional | None | $204.17 | $229.09 | $489.78 |
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 $323.59 Typical High $457.09 | Professional | None | $190.55 | $323.59 | $457.09 |
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 $138.04 Median $165.96 Typical High $190.55 | Professional | 52 · Reduced service | $138.04 | $165.96 | $190.55 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $54.95 Median $66.07 Typical High $75.86 | Professional | 53 · Discontinued | $54.95 | $66.07 | $75.86 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $208.93 Median $251.19 Typical High $288.40 | Professional | 54 · Surgery only | $208.93 | $251.19 | $288.40 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $41.69 Median $50.12 Typical High $57.54 | Professional | 55 · Aftercare only | $41.69 | $50.12 | $57.54 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $27.54 Median $33.11 Typical High $38.02 | Professional | 56 · Pre-op care only | $27.54 | $33.11 | $38.02 |
Aetna Setting Professional Modifier 78 · Unplanned return to OR Typical Low $194.98 Median $234.42 Typical High $269.15 | Professional | 78 · Unplanned return to OR | $194.98 | $234.42 | $269.15 |
Where Nevada sits
The same service costs 4.1 times more in Alaska than in New Jersey. 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· 40th of 51
$331
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.