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 $141.25 Median $1,698.24 Typical High $4,365.16 | Facility | None | $141.25 | $1,698.24 | $4,365.16 |
Aetna Setting Professional Modifier None Typical Low $141.25 Median $218.78 Typical High $251.19 | Professional | None | $141.25 | $218.78 | $251.19 |
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 $134.90 Median $239.88 Typical High $338.84 | Professional | None | $134.90 | $239.88 | $338.84 |
Cigna Setting Facility Modifier None Typical Low $208.93 Median $257.04 Typical High $549.54 | Facility | None | $208.93 | $257.04 | $549.54 |
Cigna Setting Professional Modifier None Typical Low $114.82 Median $169.82 Typical High $275.42 | Professional | None | $114.82 | $169.82 | $275.42 |
Hometown Health Setting Professional Modifier None Typical Low $109.65 Median $199.53 Typical High $323.59 | Professional | None | $109.65 | $199.53 | $323.59 |
Hometown Health Setting Facility Modifier None Typical Low $208.93 Median $208.93 Typical High $208.93 | Facility | None | $208.93 | $208.93 | $208.93 |
Hometown Health Setting Professional Modifier None Typical Low $0.42 Median $194.98 Typical High $398.11 | Professional | None | $0.42 | $194.98 | $398.11 |
Select Health Setting Facility Modifier None Typical Low $131.83 Median $269.15 Typical High $4,265.80 | Facility | None | $131.83 | $269.15 | $4,265.80 |
Select Health Setting Professional Modifier None Typical Low $112.20 Median $151.36 Typical High $269.15 | Professional | None | $112.20 | $151.36 | $269.15 |
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 $30.20 Median $190.55 Typical High $309.03 | Professional | None | $30.20 | $190.55 | $309.03 |
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 $70.79 Median $102.33 Typical High $125.89 | Professional | 52 · Reduced service | $70.79 | $102.33 | $125.89 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $28.84 Median $41.69 Typical High $50.12 | Professional | 53 · Discontinued | $28.84 | $41.69 | $50.12 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $107.15 Median $154.88 Typical High $186.21 | Professional | 54 · Surgery only | $107.15 | $154.88 | $186.21 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $21.38 Median $30.90 Typical High $37.15 | Professional | 55 · Aftercare only | $21.38 | $30.90 | $37.15 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $14.13 Median $20.42 Typical High $25.12 | Professional | 56 · Pre-op care only | $14.13 | $20.42 | $25.12 |
Aetna Setting Professional Modifier 78 · Unplanned return to OR Typical Low $100.00 Median $144.54 Typical High $173.78 | Professional | 78 · Unplanned return to OR | $100.00 | $144.54 | $173.78 |
Where Nevada sits
The same service costs 3.5 times more in Alaska than in Washington, DC. 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
$200
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.