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 $234.42 Median $1,698.24 Typical High $4,365.16 | Facility | None | $234.42 | $1,698.24 | $4,365.16 |
Aetna Setting Professional Modifier None Typical Low $234.42 Median $288.40 Typical High $371.54 | Professional | None | $234.42 | $288.40 | $371.54 |
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 $218.78 Median $346.74 Typical High $501.19 | Professional | None | $218.78 | $346.74 | $501.19 |
Cigna Setting Facility Modifier None Typical Low $269.15 Median $338.84 Typical High $912.01 | Facility | None | $269.15 | $338.84 | $912.01 |
Cigna Setting Professional Modifier None Typical Low $177.83 Median $257.04 Typical High $407.38 | Professional | None | $177.83 | $257.04 | $407.38 |
Hometown Health Setting Professional Modifier None Typical Low $169.82 Median $257.04 Typical High $457.09 | Professional | None | $169.82 | $257.04 | $457.09 |
Hometown Health Setting Facility Modifier None Typical Low $269.15 Median $269.15 Typical High $269.15 | Facility | None | $269.15 | $269.15 | $269.15 |
Hometown Health Setting Professional Modifier None Typical Low $1.20 Median $295.12 Typical High $562.34 | Professional | None | $1.20 | $295.12 | $562.34 |
Select Health Setting Facility Modifier None Typical Low $199.53 Median $380.19 Typical High $4,265.80 | Facility | None | $199.53 | $380.19 | $4,265.80 |
Select Health Setting Professional Modifier None Typical Low $165.96 Median $223.87 Typical High $398.11 | Professional | None | $165.96 | $223.87 | $398.11 |
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 $204.17 Median $281.84 Typical High $457.09 | Professional | None | $204.17 | $281.84 | $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 $117.49 Median $144.54 Typical High $186.21 | Professional | 52 · Reduced service | $117.49 | $144.54 | $186.21 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $46.77 Median $57.54 Typical High $74.13 | Professional | 53 · Discontinued | $46.77 | $57.54 | $74.13 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $177.83 Median $218.78 Typical High $281.84 | Professional | 54 · Surgery only | $177.83 | $218.78 | $281.84 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $35.48 Median $43.65 Typical High $56.23 | Professional | 55 · Aftercare only | $35.48 | $43.65 | $56.23 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $23.44 Median $28.84 Typical High $37.15 | Professional | 56 · Pre-op care only | $23.44 | $28.84 | $37.15 |
Aetna Setting Professional Modifier 78 · Unplanned return to OR Typical Low $165.96 Median $204.17 Typical High $263.03 | Professional | 78 · Unplanned return to OR | $165.96 | $204.17 | $263.03 |
Where Nevada sits
The same service costs 3.6 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· 43rd of 51
$282
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.