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 $204.17 Median $1,698.24 Typical High $4,365.16 | Facility | None | $204.17 | $1,698.24 | $4,365.16 |
Aetna Setting Professional Modifier None Typical Low $204.17 Median $263.03 Typical High $302.00 | Professional | None | $204.17 | $263.03 | $302.00 |
Ambetter Setting Professional Modifier None Typical Low $251.19 Median $295.12 Typical High $323.59 | Professional | None | $251.19 | $295.12 | $323.59 |
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 $190.55 Median $288.40 Typical High $416.87 | Professional | None | $190.55 | $288.40 | $416.87 |
Cigna Setting Facility Modifier None Typical Low $251.19 Median $309.03 Typical High $588.84 | Facility | None | $251.19 | $309.03 | $588.84 |
Cigna Setting Professional Modifier None Typical Low $123.03 Median $218.78 Typical High $338.84 | Professional | None | $123.03 | $218.78 | $338.84 |
Hometown Health Setting Professional Modifier None Typical Low $154.88 Median $234.42 Typical High $389.05 | Professional | None | $154.88 | $234.42 | $389.05 |
Hometown Health Setting Facility Modifier None Typical Low $251.19 Median $251.19 Typical High $251.19 | Facility | None | $251.19 | $251.19 | $251.19 |
Hometown Health Setting Professional Modifier None Typical Low $1.02 Median $295.12 Typical High $489.78 | Professional | None | $1.02 | $295.12 | $489.78 |
Select Health Setting Facility Modifier None Typical Low $194.98 Median $323.59 Typical High $4,265.80 | Facility | None | $194.98 | $323.59 | $4,265.80 |
Select Health Setting Professional Modifier None Typical Low $165.96 Median $186.21 Typical High $371.54 | Professional | None | $165.96 | $186.21 | $371.54 |
United Setting Facility Modifier None Typical Low $302.00 Median $512.86 Typical High $2,137.96 | Facility | None | $302.00 | $512.86 | $2,137.96 |
United Setting Professional Modifier None Typical Low $69.18 Median $218.78 Typical High $363.08 | Professional | None | $69.18 | $218.78 | $363.08 |
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 $102.33 Median $123.03 Typical High $151.36 | Professional | 52 · Reduced service | $102.33 | $123.03 | $151.36 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $40.74 Median $48.98 Typical High $60.26 | Professional | 53 · Discontinued | $40.74 | $48.98 | $60.26 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $154.88 Median $181.97 Typical High $229.09 | Professional | 54 · Surgery only | $154.88 | $181.97 | $229.09 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $30.90 Median $37.15 Typical High $45.71 | Professional | 55 · Aftercare only | $30.90 | $37.15 | $45.71 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $20.42 Median $24.55 Typical High $30.20 | Professional | 56 · Pre-op care only | $20.42 | $24.55 | $30.20 |
Aetna Setting Professional Modifier 78 · Unplanned return to OR Typical Low $144.54 Median $169.82 Typical High $213.80 | Professional | 78 · Unplanned return to OR | $144.54 | $169.82 | $213.80 |
Where Nevada sits
The same service costs 3.8 times more in Alaska than in Kentucky. 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
$240
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.