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 $239.88 Typical High $331.13 | Professional | None | $204.17 | $239.88 | $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 $194.98 Median $316.23 Typical High $457.09 | Professional | None | $194.98 | $316.23 | $457.09 |
Cigna Setting Facility Modifier None Typical Low $281.84 Median $338.84 Typical High $549.54 | Facility | None | $281.84 | $338.84 | $549.54 |
Cigna Setting Professional Modifier None Typical Low $91.20 Median $208.93 Typical High $346.74 | Professional | None | $91.20 | $208.93 | $346.74 |
Hometown Health Setting Professional Modifier None Typical Low $141.25 Median $229.09 Typical High $380.19 | Professional | None | $141.25 | $229.09 | $380.19 |
Hometown Health Setting Facility Modifier None Typical Low $281.84 Median $281.84 Typical High $281.84 | Facility | None | $281.84 | $281.84 | $281.84 |
Hometown Health Setting Professional Modifier None Typical Low $0.60 Median $288.40 Typical High $478.63 | Professional | None | $0.60 | $288.40 | $478.63 |
Select Health Setting Facility Modifier None Typical Low $190.55 Median $316.23 Typical High $4,265.80 | Facility | None | $190.55 | $316.23 | $4,265.80 |
Select Health Setting Professional Modifier None Typical Low $162.18 Median $190.55 Typical High $380.19 | Professional | None | $162.18 | $190.55 | $380.19 |
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 $83.18 Median $204.17 Typical High $380.19 | Professional | None | $83.18 | $204.17 | $380.19 |
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 $120.23 Typical High $165.96 | Professional | 52 · Reduced service | $102.33 | $120.23 | $165.96 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $40.74 Median $47.86 Typical High $66.07 | Professional | 53 · Discontinued | $40.74 | $47.86 | $66.07 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $154.88 Median $181.97 Typical High $245.47 | Professional | 54 · Surgery only | $154.88 | $181.97 | $245.47 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $30.90 Median $36.31 Typical High $48.98 | Professional | 55 · Aftercare only | $30.90 | $36.31 | $48.98 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $20.42 Median $23.44 Typical High $33.11 | Professional | 56 · Pre-op care only | $20.42 | $23.44 | $33.11 |
Aetna Setting Professional Modifier 78 · Unplanned return to OR Typical Low $144.54 Median $169.82 Typical High $229.09 | Professional | 78 · Unplanned return to OR | $144.54 | $169.82 | $229.09 |
Where Nevada sits
The same service costs 4.5 times more in Alaska 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· 42nd of 51
$234
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.