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 $112.20 Median $2,137.96 Typical High $10,715.19 | Facility | None | $112.20 | $2,137.96 | $10,715.19 |
Aetna Setting Professional Modifier None Typical Low $112.20 Median $147.91 Typical High $173.78 | Professional | None | $112.20 | $147.91 | $173.78 |
Ambetter Setting Professional Modifier None Typical Low $114.82 Median $114.82 Typical High $151.36 | Professional | None | $114.82 | $114.82 | $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 $107.15 Median $154.88 Typical High $239.88 | Professional | None | $107.15 | $154.88 | $239.88 |
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 $93.33 Median $120.23 Typical High $208.93 | Professional | None | $93.33 | $120.23 | $208.93 |
Hometown Health Setting Professional Modifier None Typical Low $97.72 Median $144.54 Typical High $229.09 | Professional | None | $97.72 | $144.54 | $229.09 |
Hometown Health Setting Professional Modifier None Typical Low $0.60 Median $147.91 Typical High $213.80 | Professional | None | $0.60 | $147.91 | $213.80 |
Select Health Setting Facility Modifier None Typical Low $97.72 Median $144.54 Typical High $4,265.80 | Facility | None | $97.72 | $144.54 | $4,265.80 |
Select Health Setting Professional Modifier None Typical Low $128.82 Median $128.82 Typical High $128.82 | Professional | None | $128.82 | $128.82 | $128.82 |
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 $91.20 Median $141.25 Typical High $213.80 | Professional | None | $91.20 | $141.25 | $213.80 |
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 $56.23 Median $74.13 Typical High $74.13 | Professional | 52 · Reduced service | $56.23 | $74.13 | $74.13 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $22.39 Median $29.51 Typical High $29.51 | Professional | 53 · Discontinued | $22.39 | $29.51 | $29.51 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $85.11 Median $109.65 Typical High $109.65 | Professional | 54 · Surgery only | $85.11 | $109.65 | $109.65 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $16.98 Median $21.88 Typical High $21.88 | Professional | 55 · Aftercare only | $16.98 | $21.88 | $21.88 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $11.22 Median $14.79 Typical High $14.79 | Professional | 56 · Pre-op care only | $11.22 | $14.79 | $14.79 |
Aetna Setting Professional Modifier 78 · Unplanned return to OR Typical Low $79.43 Median $102.33 Typical High $102.33 | Professional | 78 · Unplanned return to OR | $79.43 | $102.33 | $102.33 |
Where Nevada sits
The same service costs 4.1 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· 42nd of 51
$148
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.