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 $114.82 Median $1,698.24 Typical High $4,365.16 | Facility | None | $114.82 | $1,698.24 | $4,365.16 |
Aetna Setting Professional Modifier None Typical Low $114.82 Median $138.04 Typical High $154.88 | Professional | None | $114.82 | $138.04 | $154.88 |
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 $107.15 Median $147.91 Typical High $234.42 | Professional | None | $107.15 | $147.91 | $234.42 |
Cigna Setting Facility Modifier None Typical Low $104.71 Median $131.83 Typical High $549.54 | Facility | None | $104.71 | $131.83 | $549.54 |
Cigna Setting Professional Modifier None Typical Low $93.33 Median $128.82 Typical High $186.21 | Professional | None | $93.33 | $128.82 | $186.21 |
Hometown Health Setting Professional Modifier None Typical Low $89.13 Median $123.03 Typical High $186.21 | Professional | None | $89.13 | $123.03 | $186.21 |
Hometown Health Setting Facility Modifier None Typical Low $104.71 Median $104.71 Typical High $104.71 | Facility | None | $104.71 | $104.71 | $104.71 |
Hometown Health Setting Professional Modifier None Typical Low $0.48 Median $151.36 Typical High $223.87 | Professional | None | $0.48 | $151.36 | $223.87 |
Select Health Setting Facility Modifier None Typical Low $100.00 Median $147.91 Typical High $4,265.80 | Facility | None | $100.00 | $147.91 | $4,265.80 |
Select Health Setting Professional Modifier None Typical Low $85.11 Median $95.50 Typical High $186.21 | Professional | None | $85.11 | $95.50 | $186.21 |
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 $56.23 Median $131.83 Typical High $190.55 | Professional | None | $56.23 | $131.83 | $190.55 |
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 $57.54 Median $67.61 Typical High $77.62 | Professional | 52 · Reduced service | $57.54 | $67.61 | $77.62 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $22.91 Median $26.92 Typical High $30.90 | Professional | 53 · Discontinued | $22.91 | $26.92 | $30.90 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $85.11 Median $102.33 Typical High $114.82 | Professional | 54 · Surgery only | $85.11 | $102.33 | $114.82 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $16.98 Median $20.42 Typical High $23.44 | Professional | 55 · Aftercare only | $16.98 | $20.42 | $23.44 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $11.48 Median $13.49 Typical High $15.49 | Professional | 56 · Pre-op care only | $11.48 | $13.49 | $15.49 |
Aetna Setting Professional Modifier 78 · Unplanned return to OR Typical Low $79.43 Median $95.50 Typical High $107.15 | Professional | 78 · Unplanned return to OR | $79.43 | $95.50 | $107.15 |
Where Nevada sits
The same service costs 4.0 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· 44th of 51
$132
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.