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 $147.91 Median $1,698.24 Typical High $4,365.16 | Facility | None | $147.91 | $1,698.24 | $4,365.16 |
Aetna Setting Professional Modifier None Typical Low $147.91 Median $213.80 Typical High $245.47 | Professional | None | $147.91 | $213.80 | $245.47 |
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 $141.25 Median $234.42 Typical High $338.84 | Professional | None | $141.25 | $234.42 | $338.84 |
Cigna Setting Facility Modifier None Typical Low $173.78 Median $218.78 Typical High $512.86 | Facility | None | $173.78 | $218.78 | $512.86 |
Cigna Setting Professional Modifier None Typical Low $125.89 Median $181.97 Typical High $281.84 | Professional | None | $125.89 | $181.97 | $281.84 |
Hometown Health Setting Professional Modifier None Typical Low $120.23 Median $194.98 Typical High $288.40 | Professional | None | $120.23 | $194.98 | $288.40 |
Hometown Health Setting Facility Modifier None Typical Low $173.78 Median $173.78 Typical High $173.78 | Facility | None | $173.78 | $173.78 | $173.78 |
Hometown Health Setting Professional Modifier None Typical Low $0.72 Median $190.55 Typical High $346.74 | Professional | None | $0.72 | $190.55 | $346.74 |
Select Health Setting Facility Modifier None Typical Low $128.82 Median $229.09 Typical High $4,265.80 | Facility | None | $128.82 | $229.09 | $4,265.80 |
Select Health Setting Professional Modifier None Typical Low $109.65 Median $141.25 Typical High $257.04 | Professional | None | $109.65 | $141.25 | $257.04 |
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 $60.26 Median $204.17 Typical High $288.40 | Professional | None | $60.26 | $204.17 | $288.40 |
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 $74.13 Median $102.33 Typical High $123.03 | Professional | 52 · Reduced service | $74.13 | $102.33 | $123.03 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $29.51 Median $40.74 Typical High $48.98 | Professional | 53 · Discontinued | $29.51 | $40.74 | $48.98 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $112.20 Median $154.88 Typical High $181.97 | Professional | 54 · Surgery only | $112.20 | $154.88 | $181.97 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $22.39 Median $30.90 Typical High $37.15 | Professional | 55 · Aftercare only | $22.39 | $30.90 | $37.15 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $14.79 Median $20.42 Typical High $24.55 | Professional | 56 · Pre-op care only | $14.79 | $20.42 | $24.55 |
Aetna Setting Professional Modifier 78 · Unplanned return to OR Typical Low $104.71 Median $144.54 Typical High $169.82 | Professional | 78 · Unplanned return to OR | $104.71 | $144.54 | $169.82 |
Where Nevada sits
The same service costs 3.5 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· 41st of 51
$204
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.