How much rates vary
Facilitymedian $3,162 · 10th to 90th $912 to $5,754Professionalmedian $309 · 10th to 90th $245 to $417
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 $309.03 Median $2,570.40 Typical High $6,165.95 | Facility | None | $309.03 | $2,570.40 | $6,165.95 |
Aetna Setting Professional Modifier None Typical Low $302.00 Median $309.03 Typical High $323.59 | Professional | None | $302.00 | $309.03 | $323.59 |
Ambetter Setting Professional Modifier None Typical Low $257.04 Median $446.68 Typical High $446.68 | Professional | None | $257.04 | $446.68 | $446.68 |
Anthem BCBS Setting Facility Modifier None Typical Low $2,951.21 Median $4,677.35 Typical High $6,165.95 | Facility | None | $2,951.21 | $4,677.35 | $6,165.95 |
Anthem BCBS Setting Professional Modifier None Typical Low $288.40 Median $323.59 Typical High $524.81 | Professional | None | $288.40 | $323.59 | $524.81 |
Cigna Setting Facility Modifier None Typical Low $616.60 Median $3,162.28 Typical High $4,570.88 | Facility | None | $616.60 | $3,162.28 | $4,570.88 |
Cigna Setting Professional Modifier None Typical Low $245.47 Median $251.19 Typical High $407.38 | Professional | None | $245.47 | $251.19 | $407.38 |
Hometown Health Setting Professional Modifier None Typical Low $4.90 Median $263.03 Typical High $389.05 | Professional | None | $4.90 | $263.03 | $389.05 |
Hometown Health Setting Facility Modifier None Typical Low $3,162.28 Median $3,162.28 Typical High $3,162.28 | Facility | None | $3,162.28 | $3,162.28 | $3,162.28 |
Hometown Health Setting Professional Modifier None Typical Low $3.63 Median $3.63 Typical High $389.05 | Professional | None | $3.63 | $3.63 | $389.05 |
Select Health Setting Facility Modifier None Typical Low $257.04 Median $257.04 Typical High $4,265.80 | Facility | None | $257.04 | $257.04 | $4,265.80 |
Select Health Setting Professional Modifier None Typical Low $186.21 Median $234.42 Typical High $524.81 | Professional | None | $186.21 | $234.42 | $524.81 |
United Setting Facility Modifier None Typical Low $954.99 Median $1,318.26 Typical High $3,311.31 | Facility | None | $954.99 | $1,318.26 | $3,311.31 |
United Setting Professional Modifier None Typical Low $245.47 Median $288.40 Typical High $389.05 | Professional | None | $245.47 | $288.40 | $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 $151.36 Median $151.36 Typical High $151.36 | Professional | 52 · Reduced service | $151.36 | $151.36 | $151.36 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $61.66 Median $61.66 Typical High $61.66 | Professional | 53 · Discontinued | $61.66 | $61.66 | $61.66 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $229.09 Median $229.09 Typical High $229.09 | Professional | 54 · Surgery only | $229.09 | $229.09 | $229.09 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $45.71 Median $45.71 Typical High $45.71 | Professional | 55 · Aftercare only | $45.71 | $45.71 | $45.71 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $30.90 Median $30.90 Typical High $30.90 | Professional | 56 · Pre-op care only | $30.90 | $30.90 | $30.90 |
Aetna Setting Professional Modifier 78 · Unplanned return to OR Typical Low $213.80 Median $213.80 Typical High $213.80 | Professional | 78 · Unplanned return to OR | $213.80 | $213.80 | $213.80 |
Where Nevada sits
The same service costs 5.5 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· 40th of 51
$309
AK $1,202UT $219
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.