How much rates vary
Facilitymedian $2,291 · 10th to 90th $912 to $5,012Professionalmedian $219 · 10th to 90th $166 to $302
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 $223.87 Median $3,162.28 Typical High $7,244.36 | Facility | None | $223.87 | $3,162.28 | $7,244.36 |
Aetna Setting Professional Modifier None Typical Low $223.87 Median $223.87 Typical High $229.09 | Professional | None | $223.87 | $223.87 | $229.09 |
Ambetter Setting Professional Modifier None Typical Low $169.82 Median $169.82 Typical High $169.82 | Professional | None | $169.82 | $169.82 | $169.82 |
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 $208.93 Median $239.88 Typical High $389.05 | Professional | None | $208.93 | $239.88 | $389.05 |
Cigna Setting Facility Modifier None Typical Low $691.83 Median $1,621.81 Typical High $2,238.72 | Facility | None | $691.83 | $1,621.81 | $2,238.72 |
Cigna Setting Professional Modifier None Typical Low $151.36 Median $177.83 Typical High $295.12 | Professional | None | $151.36 | $177.83 | $295.12 |
Hometown Health Setting Professional Modifier None Typical Low $2.82 Median $194.98 Typical High $281.84 | Professional | None | $2.82 | $194.98 | $281.84 |
Hometown Health Setting Facility Modifier None Typical Low $1,548.82 Median $1,548.82 Typical High $1,548.82 | Facility | None | $1,548.82 | $1,548.82 | $1,548.82 |
Hometown Health Setting Professional Modifier None Typical Low $2.09 Median $2.09 Typical High $288.40 | Professional | None | $2.09 | $2.09 | $288.40 |
Select Health Setting Facility Modifier None Typical Low $194.98 Median $194.98 Typical High $4,265.80 | Facility | None | $194.98 | $194.98 | $4,265.80 |
Select Health Setting Professional Modifier None Typical Low $134.90 Median $177.83 Typical High $389.05 | Professional | None | $134.90 | $177.83 | $389.05 |
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 $165.96 Median $208.93 Typical High $275.42 | Professional | None | $165.96 | $208.93 | $275.42 |
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 $112.20 Median $112.20 Typical High $112.20 | Professional | 52 · Reduced service | $112.20 | $112.20 | $112.20 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $44.67 Median $44.67 Typical High $44.67 | Professional | 53 · Discontinued | $44.67 | $44.67 | $44.67 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $165.96 Median $165.96 Typical High $165.96 | Professional | 54 · Surgery only | $165.96 | $165.96 | $165.96 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $33.11 Median $33.11 Typical High $33.11 | Professional | 55 · Aftercare only | $33.11 | $33.11 | $33.11 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $22.39 Median $22.39 Typical High $22.39 | Professional | 56 · Pre-op care only | $22.39 | $22.39 | $22.39 |
Aetna Setting Professional Modifier 78 · Unplanned return to OR Typical Low $154.88 Median $154.88 Typical High $154.88 | Professional | 78 · Unplanned return to OR | $154.88 | $154.88 | $154.88 |
Where Nevada sits
The same service costs 5.6 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
$224
AK $871UT $155
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.