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 $436.52 Median $1,698.24 Typical High $4,466.84 | Facility | None | $436.52 | $1,698.24 | $4,466.84 |
Aetna Setting Professional Modifier None Typical Low $436.52 Median $436.52 Typical High $436.52 | Professional | None | $436.52 | $436.52 | $436.52 |
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 $407.38 Median $467.74 Typical High $758.58 | Professional | None | $407.38 | $467.74 | $758.58 |
Cigna Setting Facility Modifier None Typical Low $128.82 Median $147.91 Typical High $234.42 | Facility | None | $128.82 | $147.91 | $234.42 |
Cigna Setting Professional Modifier None Typical Low $177.83 Median $346.74 Typical High $537.03 | Professional | None | $177.83 | $346.74 | $537.03 |
Hometown Health Setting Professional Modifier None Typical Low $2.63 Median $371.54 Typical High $524.81 | Professional | None | $2.63 | $371.54 | $524.81 |
Hometown Health Setting Facility Modifier None Typical Low $134.90 Median $134.90 Typical High $134.90 | Facility | None | $134.90 | $134.90 | $134.90 |
Hometown Health Setting Professional Modifier None Typical Low $2.00 Median $2.00 Typical High $537.03 | Professional | None | $2.00 | $2.00 | $537.03 |
Select Health Setting Facility Modifier None Typical Low $363.08 Median $363.08 Typical High $4,265.80 | Facility | None | $363.08 | $363.08 | $4,265.80 |
Select Health Setting Professional Modifier None Typical Low $257.04 Median $323.59 Typical High $676.08 | Professional | None | $257.04 | $323.59 | $676.08 |
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 $181.97 Median $389.05 Typical High $512.86 | Professional | None | $181.97 | $389.05 | $512.86 |
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 $218.78 Median $218.78 Typical High $218.78 | Professional | 52 · Reduced service | $218.78 | $218.78 | $218.78 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $87.10 Median $87.10 Typical High $87.10 | Professional | 53 · Discontinued | $87.10 | $87.10 | $87.10 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $323.59 Median $323.59 Typical High $323.59 | Professional | 54 · Surgery only | $323.59 | $323.59 | $323.59 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $64.57 Median $64.57 Typical High $64.57 | Professional | 55 · Aftercare only | $64.57 | $64.57 | $64.57 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $43.65 Median $43.65 Typical High $43.65 | Professional | 56 · Pre-op care only | $43.65 | $43.65 | $43.65 |
Aetna Setting Professional Modifier 78 · Unplanned return to OR Typical Low $302.00 Median $302.00 Typical High $302.00 | Professional | 78 · Unplanned return to OR | $302.00 | $302.00 | $302.00 |
Where Nevada sits
The same service costs 4.2 times more in Wyoming 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· 38th of 51
$427
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.