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 $169.82 Median $2,238.72 Typical High $5,011.87 | Facility | None | $169.82 | $2,238.72 | $5,011.87 |
Aetna Setting Professional Modifier None Typical Low $169.82 Median $239.88 Typical High $269.15 | Professional | None | $169.82 | $239.88 | $269.15 |
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 $162.18 Median $257.04 Typical High $389.05 | Professional | None | $162.18 | $257.04 | $389.05 |
Cigna Setting Facility Modifier None Typical Low $190.55 Median $239.88 Typical High $676.08 | Facility | None | $190.55 | $239.88 | $676.08 |
Cigna Setting Professional Modifier None Typical Low $147.91 Median $213.80 Typical High $316.23 | Professional | None | $147.91 | $213.80 | $316.23 |
Hometown Health Setting Professional Modifier None Typical Low $144.54 Median $223.87 Typical High $331.13 | Professional | None | $144.54 | $223.87 | $331.13 |
Hometown Health Setting Facility Modifier None Typical Low $190.55 Median $190.55 Typical High $190.55 | Facility | None | $190.55 | $190.55 | $190.55 |
Hometown Health Setting Professional Modifier None Typical Low $1.07 Median $223.87 Typical High $389.05 | Professional | None | $1.07 | $223.87 | $389.05 |
Select Health Setting Facility Modifier None Typical Low $147.91 Median $263.03 Typical High $4,265.80 | Facility | None | $147.91 | $263.03 | $4,265.80 |
Select Health Setting Professional Modifier None Typical Low $125.89 Median $158.49 Typical High $302.00 | Professional | None | $125.89 | $158.49 | $302.00 |
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 $162.18 Median $223.87 Typical High $323.59 | Professional | None | $162.18 | $223.87 | $323.59 |
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 $85.11 Median $117.49 Typical High $134.90 | Professional | 52 · Reduced service | $85.11 | $117.49 | $134.90 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $33.88 Median $46.77 Typical High $53.70 | Professional | 53 · Discontinued | $33.88 | $46.77 | $53.70 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $128.82 Median $173.78 Typical High $204.17 | Professional | 54 · Surgery only | $128.82 | $173.78 | $204.17 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $25.70 Median $34.67 Typical High $40.74 | Professional | 55 · Aftercare only | $25.70 | $34.67 | $40.74 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $16.98 Median $23.44 Typical High $26.92 | Professional | 56 · Pre-op care only | $16.98 | $23.44 | $26.92 |
Aetna Setting Professional Modifier 78 · Unplanned return to OR Typical Low $120.23 Median $162.18 Typical High $190.55 | Professional | 78 · Unplanned return to OR | $120.23 | $162.18 | $190.55 |
Where Nevada sits
The same service costs 3.6 times more in Alaska than in Texas. 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
$229
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.