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 $316.23 Median $2,137.96 Typical High $10,715.19 | Facility | None | $316.23 | $2,137.96 | $10,715.19 |
Aetna Setting Professional Modifier None Typical Low $316.23 Median $416.87 Typical High $489.78 | Professional | None | $316.23 | $416.87 | $489.78 |
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 $295.12 Median $467.74 Typical High $676.08 | Professional | None | $295.12 | $467.74 | $676.08 |
Cigna Setting Facility Modifier None Typical Low $416.87 Median $524.81 Typical High $977.24 | Facility | None | $416.87 | $524.81 | $977.24 |
Cigna Setting Professional Modifier None Typical Low $169.82 Median $346.74 Typical High $524.81 | Professional | None | $169.82 | $346.74 | $524.81 |
Hometown Health Setting Professional Modifier None Typical Low $218.78 Median $354.81 Typical High $616.60 | Professional | None | $218.78 | $354.81 | $616.60 |
Hometown Health Setting Facility Modifier None Typical Low $416.87 Median $416.87 Typical High $416.87 | Facility | None | $416.87 | $416.87 | $416.87 |
Hometown Health Setting Professional Modifier None Typical Low $1.74 Median $446.68 Typical High $758.58 | Professional | None | $1.74 | $446.68 | $758.58 |
Select Health Setting Facility Modifier None Typical Low $295.12 Median $512.86 Typical High $4,265.80 | Facility | None | $295.12 | $512.86 | $4,265.80 |
Select Health Setting Professional Modifier None Typical Low $251.19 Median $295.12 Typical High $588.84 | Professional | None | $251.19 | $295.12 | $588.84 |
United Setting Facility Modifier None Typical Low $1,621.81 Median $2,398.83 Typical High $6,165.95 | Facility | None | $1,621.81 | $2,398.83 | $6,165.95 |
United Setting Professional Modifier None Typical Low $204.17 Median $331.13 Typical High $588.84 | Professional | None | $204.17 | $331.13 | $588.84 |
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 $158.49 Median $181.97 Typical High $245.47 | Professional | 52 · Reduced service | $158.49 | $181.97 | $245.47 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $63.10 Median $72.44 Typical High $97.72 | Professional | 53 · Discontinued | $63.10 | $72.44 | $97.72 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $234.42 Median $275.42 Typical High $371.54 | Professional | 54 · Surgery only | $234.42 | $275.42 | $371.54 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $47.86 Median $54.95 Typical High $74.13 | Professional | 55 · Aftercare only | $47.86 | $54.95 | $74.13 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $31.62 Median $36.31 Typical High $48.98 | Professional | 56 · Pre-op care only | $31.62 | $36.31 | $48.98 |
Aetna Setting Professional Modifier 78 · Unplanned return to OR Typical Low $218.78 Median $257.04 Typical High $346.74 | Professional | 78 · Unplanned return to OR | $218.78 | $257.04 | $346.74 |
Where Nevada sits
The same service costs 4.3 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· 41st of 51
$363
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.