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 $257.04 Median $3,162.28 Typical High $7,244.36 | Facility | None | $257.04 | $3,162.28 | $7,244.36 |
Aetna Setting Professional Modifier None Typical Low $257.04 Median $257.04 Typical High $257.04 | Professional | None | $257.04 | $257.04 | $257.04 |
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 $239.88 Median $275.42 Typical High $446.68 | Professional | None | $239.88 | $275.42 | $446.68 |
Cigna Setting Facility Modifier None Typical Low $724.44 Median $1,621.81 Typical High $2,238.72 | Facility | None | $724.44 | $1,621.81 | $2,238.72 |
Cigna Setting Professional Modifier None Typical Low $208.93 Median $208.93 Typical High $346.74 | Professional | None | $208.93 | $208.93 | $346.74 |
Hometown Health Setting Professional Modifier None Typical Low $2.82 Median $218.78 Typical High $323.59 | Professional | None | $2.82 | $218.78 | $323.59 |
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 $331.13 | Professional | None | $2.09 | $2.09 | $331.13 |
Select Health Setting Facility Modifier None Typical Low $218.78 Median $218.78 Typical High $4,265.80 | Facility | None | $218.78 | $218.78 | $4,265.80 |
Select Health Setting Professional Modifier None Typical Low $158.49 Median $204.17 Typical High $446.68 | Professional | None | $158.49 | $204.17 | $446.68 |
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 $204.17 Median $239.88 Typical High $323.59 | Professional | None | $204.17 | $239.88 | $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 $128.82 Median $128.82 Typical High $128.82 | Professional | 52 · Reduced service | $128.82 | $128.82 | $128.82 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $51.29 Median $51.29 Typical High $51.29 | Professional | 53 · Discontinued | $51.29 | $51.29 | $51.29 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $190.55 Median $190.55 Typical High $190.55 | Professional | 54 · Surgery only | $190.55 | $190.55 | $190.55 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $38.02 Median $38.02 Typical High $38.02 | Professional | 55 · Aftercare only | $38.02 | $38.02 | $38.02 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $25.70 Median $25.70 Typical High $25.70 | Professional | 56 · Pre-op care only | $25.70 | $25.70 | $25.70 |
Aetna Setting Professional Modifier 78 · Unplanned return to OR Typical Low $177.83 Median $177.83 Typical High $177.83 | Professional | 78 · Unplanned return to OR | $177.83 | $177.83 | $177.83 |
Where Nevada sits
The same service costs 6.0 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· 41st of 51
$257
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.