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 $186.21 Median $1,698.24 Typical High $4,365.16 | Facility | None | $186.21 | $1,698.24 | $4,365.16 |
Aetna Setting Professional Modifier None Typical Low $186.21 Median $234.42 Typical High $275.42 | Professional | None | $186.21 | $234.42 | $275.42 |
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 $173.78 Median $263.03 Typical High $380.19 | Professional | None | $173.78 | $263.03 | $380.19 |
Cigna Setting Facility Modifier None Typical Low $302.00 Median $354.81 Typical High $524.81 | Facility | None | $302.00 | $354.81 | $524.81 |
Cigna Setting Professional Modifier None Typical Low $151.36 Median $213.80 Typical High $316.23 | Professional | None | $151.36 | $213.80 | $316.23 |
Hometown Health Setting Professional Modifier None Typical Low $141.25 Median $208.93 Typical High $363.08 | Professional | None | $141.25 | $208.93 | $363.08 |
Hometown Health Setting Facility Modifier None Typical Low $309.03 Median $309.03 Typical High $309.03 | Facility | None | $309.03 | $309.03 | $309.03 |
Hometown Health Setting Professional Modifier None Typical Low $2.00 Median $239.88 Typical High $467.74 | Professional | None | $2.00 | $239.88 | $467.74 |
Select Health Setting Facility Modifier None Typical Low $158.49 Median $257.04 Typical High $4,265.80 | Facility | None | $158.49 | $257.04 | $4,265.80 |
Select Health Setting Professional Modifier None Typical Low $134.90 Median $162.18 Typical High $323.59 | Professional | None | $134.90 | $162.18 | $323.59 |
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 $91.20 Median $218.78 Typical High $323.59 | Professional | None | $91.20 | $218.78 | $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 $93.33 Median $117.49 Typical High $138.04 | Professional | 52 · Reduced service | $93.33 | $117.49 | $138.04 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $37.15 Median $46.77 Typical High $54.95 | Professional | 53 · Discontinued | $37.15 | $46.77 | $54.95 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $141.25 Median $177.83 Typical High $208.93 | Professional | 54 · Surgery only | $141.25 | $177.83 | $208.93 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $28.18 Median $35.48 Typical High $41.69 | Professional | 55 · Aftercare only | $28.18 | $35.48 | $41.69 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $18.62 Median $23.44 Typical High $27.54 | Professional | 56 · Pre-op care only | $18.62 | $23.44 | $27.54 |
Aetna Setting Professional Modifier 78 · Unplanned return to OR Typical Low $131.83 Median $165.96 Typical High $194.98 | Professional | 78 · Unplanned return to OR | $131.83 | $165.96 | $194.98 |
Where Nevada sits
The same service costs 4.2 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· 41st of 51
$224
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.