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 $107.15 Median $2,137.96 Typical High $10,715.19 | Facility | None | $107.15 | $2,137.96 | $10,715.19 |
Aetna Setting Professional Modifier None Typical Low $107.15 Median $147.91 Typical High $151.36 | Professional | None | $107.15 | $147.91 | $151.36 |
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 $102.33 Median $147.91 Typical High $234.42 | Professional | None | $102.33 | $147.91 | $234.42 |
Cigna Setting Facility Modifier None Typical Low $54.95 Median $741.31 Typical High $2,137.96 | Facility | None | $54.95 | $741.31 | $2,137.96 |
Cigna Setting Professional Modifier None Typical Low $87.10 Median $109.65 Typical High $194.98 | Professional | None | $87.10 | $109.65 | $194.98 |
Hometown Health Setting Professional Modifier None Typical Low $95.50 Median $144.54 Typical High $234.42 | Professional | None | $95.50 | $144.54 | $234.42 |
Hometown Health Setting Professional Modifier None Typical Low $0.30 Median $144.54 Typical High $218.78 | Professional | None | $0.30 | $144.54 | $218.78 |
Select Health Setting Facility Modifier None Typical Low $95.50 Median $144.54 Typical High $4,265.80 | Facility | None | $95.50 | $144.54 | $4,265.80 |
Select Health Setting Professional Modifier None Typical Low $131.83 Median $131.83 Typical High $131.83 | Professional | None | $131.83 | $131.83 | $131.83 |
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 $87.10 Median $134.90 Typical High $208.93 | Professional | None | $87.10 | $134.90 | $208.93 |
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 $53.70 Median $74.13 Typical High $74.13 | Professional | 52 · Reduced service | $53.70 | $74.13 | $74.13 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $21.38 Median $29.51 Typical High $29.51 | Professional | 53 · Discontinued | $21.38 | $29.51 | $29.51 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $81.28 Median $109.65 Typical High $109.65 | Professional | 54 · Surgery only | $81.28 | $109.65 | $109.65 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $16.22 Median $21.88 Typical High $21.88 | Professional | 55 · Aftercare only | $16.22 | $21.88 | $21.88 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $10.72 Median $14.79 Typical High $14.79 | Professional | 56 · Pre-op care only | $10.72 | $14.79 | $14.79 |
Aetna Setting Professional Modifier 78 · Unplanned return to OR Typical Low $75.86 Median $102.33 Typical High $102.33 | Professional | 78 · Unplanned return to OR | $75.86 | $102.33 | $102.33 |
Where Nevada sits
The same service costs 4.2 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· 40th of 51
$145
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.