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 $112.20 Median $1,698.24 Typical High $4,365.16 | Facility | None | $112.20 | $1,698.24 | $4,365.16 |
Aetna Setting Professional Modifier None Typical Low $112.20 Median $154.88 Typical High $186.21 | Professional | None | $112.20 | $154.88 | $186.21 |
Anthem BCBS Setting Facility Modifier None Typical Low $2,238.72 Median $3,548.13 Typical High $4,466.84 | Facility | None | $2,238.72 | $3,548.13 | $4,466.84 |
Anthem BCBS Setting Professional Modifier None Typical Low $107.15 Median $177.83 Typical High $257.04 | Professional | None | $107.15 | $177.83 | $257.04 |
Cigna Setting Facility Modifier None Typical Low $125.89 Median $144.54 Typical High $229.09 | Facility | None | $125.89 | $144.54 | $229.09 |
Cigna Setting Professional Modifier None Typical Low $95.50 Median $134.90 Typical High $208.93 | Professional | None | $95.50 | $134.90 | $208.93 |
Hometown Health Setting Professional Modifier None Typical Low $91.20 Median $138.04 Typical High $218.78 | Professional | None | $91.20 | $138.04 | $218.78 |
Hometown Health Setting Facility Modifier None Typical Low $131.83 Median $131.83 Typical High $131.83 | Facility | None | $131.83 | $131.83 | $131.83 |
Hometown Health Setting Professional Modifier None Typical Low $0.30 Median $144.54 Typical High $275.42 | Professional | None | $0.30 | $144.54 | $275.42 |
Select Health Setting Facility Modifier None Typical Low $97.72 Median $181.97 Typical High $4,265.80 | Facility | None | $97.72 | $181.97 | $4,265.80 |
Select Health Setting Professional Modifier None Typical Low $83.18 Median $109.65 Typical High $194.98 | Professional | None | $83.18 | $109.65 | $194.98 |
United Setting Facility Modifier None Typical Low $97.72 Median $245.47 Typical High $1,949.84 | Facility | None | $97.72 | $245.47 | $1,949.84 |
United Setting Professional Modifier None Typical Low $102.33 Median $141.25 Typical High $218.78 | Professional | None | $102.33 | $141.25 | $218.78 |
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 $56.23 Median $75.86 Typical High $93.33 | Professional | 52 · Reduced service | $56.23 | $75.86 | $93.33 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $22.39 Median $30.20 Typical High $37.15 | Professional | 53 · Discontinued | $22.39 | $30.20 | $37.15 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $85.11 Median $114.82 Typical High $138.04 | Professional | 54 · Surgery only | $85.11 | $114.82 | $138.04 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $16.98 Median $22.91 Typical High $27.54 | Professional | 55 · Aftercare only | $16.98 | $22.91 | $27.54 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $11.22 Median $15.14 Typical High $18.62 | Professional | 56 · Pre-op care only | $11.22 | $15.14 | $18.62 |
Aetna Setting Professional Modifier 78 · Unplanned return to OR Typical Low $79.43 Median $107.15 Typical High $128.82 | Professional | 78 · Unplanned return to OR | $79.43 | $107.15 | $128.82 |
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· 45th of 51
$141
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.