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 $239.88 Median $2,238.72 Typical High $5,011.87 | Facility | None | $239.88 | $2,238.72 | $5,011.87 |
Aetna Setting Professional Modifier None Typical Low $239.88 Median $281.84 Typical High $316.23 | Professional | None | $239.88 | $281.84 | $316.23 |
Ambetter Setting Professional Modifier None Typical Low $616.60 Median $616.60 Typical High $616.60 | Professional | None | $616.60 | $616.60 | $616.60 |
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 $223.87 Median $302.00 Typical High $478.63 | Professional | None | $223.87 | $302.00 | $478.63 |
Cigna Setting Facility Modifier None Typical Low $501.19 Median $724.44 Typical High $1,000.00 | Facility | None | $501.19 | $724.44 | $1,000.00 |
Cigna Setting Professional Modifier None Typical Low $190.55 Median $257.04 Typical High $380.19 | Professional | None | $190.55 | $257.04 | $380.19 |
Hometown Health Setting Professional Modifier None Typical Low $181.97 Median $257.04 Typical High $537.03 | Professional | None | $181.97 | $257.04 | $537.03 |
Hometown Health Setting Facility Modifier None Typical Low $691.83 Median $691.83 Typical High $691.83 | Facility | None | $691.83 | $691.83 | $691.83 |
Hometown Health Setting Professional Modifier None Typical Low $1.62 Median $302.00 Typical High $1,023.29 | Professional | None | $1.62 | $302.00 | $1,023.29 |
Select Health Setting Facility Modifier None Typical Low $199.53 Median $302.00 Typical High $4,265.80 | Facility | None | $199.53 | $302.00 | $4,265.80 |
Select Health Setting Professional Modifier None Typical Low $169.82 Median $190.55 Typical High $407.38 | Professional | None | $169.82 | $190.55 | $407.38 |
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 $169.82 Median $269.15 Typical High $389.05 | Professional | None | $169.82 | $269.15 | $389.05 |
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 $117.49 Median $141.25 Typical High $158.49 | Professional | 52 · Reduced service | $117.49 | $141.25 | $158.49 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $47.86 Median $56.23 Typical High $63.10 | Professional | 53 · Discontinued | $47.86 | $56.23 | $63.10 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $177.83 Median $208.93 Typical High $239.88 | Professional | 54 · Surgery only | $177.83 | $208.93 | $239.88 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $35.48 Median $42.66 Typical High $47.86 | Professional | 55 · Aftercare only | $35.48 | $42.66 | $47.86 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $23.99 Median $28.18 Typical High $31.62 | Professional | 56 · Pre-op care only | $23.99 | $28.18 | $31.62 |
Aetna Setting Professional Modifier 78 · Unplanned return to OR Typical Low $165.96 Median $194.98 Typical High $223.87 | Professional | 78 · Unplanned return to OR | $165.96 | $194.98 | $223.87 |
Where Nevada sits
The same service costs 4.3 times more in Alaska than in Utah. 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· 39th of 51
$275
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.