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 $194.98 Median $2,137.96 Typical High $10,715.19 | Facility | None | $194.98 | $2,137.96 | $10,715.19 |
Aetna Setting Professional Modifier None Typical Low $194.98 Median $223.87 Typical High $331.13 | Professional | None | $194.98 | $223.87 | $331.13 |
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 $186.21 Median $302.00 Typical High $407.38 | Professional | None | $186.21 | $302.00 | $407.38 |
Cigna Setting Facility Modifier None Typical Low $309.03 Median $380.19 Typical High $912.01 | Facility | None | $309.03 | $380.19 | $912.01 |
Cigna Setting Professional Modifier None Typical Low $107.15 Median $194.98 Typical High $338.84 | Professional | None | $107.15 | $194.98 | $338.84 |
Hometown Health Setting Professional Modifier None Typical Low $104.71 Median $223.87 Typical High $426.58 | Professional | None | $104.71 | $223.87 | $426.58 |
Hometown Health Setting Facility Modifier None Typical Low $309.03 Median $309.03 Typical High $309.03 | Facility | None | $309.03 | $309.03 | $309.03 |
Hometown Health Setting Professional Modifier None Typical Low $0.42 Median $288.40 Typical High $537.03 | Professional | None | $0.42 | $288.40 | $537.03 |
Select Health Setting Facility Modifier None Typical Low $194.98 Median $354.81 Typical High $4,265.80 | Facility | None | $194.98 | $354.81 | $4,265.80 |
Select Health Setting Professional Modifier None Typical Low $165.96 Median $194.98 Typical High $380.19 | Professional | None | $165.96 | $194.98 | $380.19 |
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 $36.31 Median $194.98 Typical High $389.05 | Professional | None | $36.31 | $194.98 | $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 $97.72 Median $109.65 Typical High $165.96 | Professional | 52 · Reduced service | $97.72 | $109.65 | $165.96 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $38.90 Median $43.65 Typical High $67.61 | Professional | 53 · Discontinued | $38.90 | $43.65 | $67.61 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $147.91 Median $162.18 Typical High $251.19 | Professional | 54 · Surgery only | $147.91 | $162.18 | $251.19 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $29.51 Median $32.36 Typical High $50.12 | Professional | 55 · Aftercare only | $29.51 | $32.36 | $50.12 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $19.50 Median $21.88 Typical High $33.11 | Professional | 56 · Pre-op care only | $19.50 | $21.88 | $33.11 |
Aetna Setting Professional Modifier 78 · Unplanned return to OR Typical Low $138.04 Median $151.36 Typical High $234.42 | Professional | 78 · Unplanned return to OR | $138.04 | $151.36 | $234.42 |
Where Nevada sits
The same service costs 4.5 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· 43rd of 51
$214
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.