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 $117.49 Median $1,698.24 Typical High $4,365.16 | Facility | None | $117.49 | $1,698.24 | $4,365.16 |
Aetna Setting Professional Modifier None Typical Low $104.71 Median $138.04 Typical High $194.98 | Professional | None | $104.71 | $138.04 | $194.98 |
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 $109.65 Median $186.21 Typical High $269.15 | Professional | None | $109.65 | $186.21 | $269.15 |
Cigna Setting Facility Modifier None Typical Low $117.49 Median $144.54 Typical High $549.54 | Facility | None | $117.49 | $144.54 | $549.54 |
Cigna Setting Professional Modifier None Typical Low $77.62 Median $104.71 Typical High $229.09 | Professional | None | $77.62 | $104.71 | $229.09 |
Hometown Health Setting Professional Modifier None Typical Low $93.33 Median $138.04 Typical High $269.15 | Professional | None | $93.33 | $138.04 | $269.15 |
Hometown Health Setting Facility Modifier None Typical Low $117.49 Median $117.49 Typical High $117.49 | Facility | None | $117.49 | $117.49 | $117.49 |
Hometown Health Setting Professional Modifier None Typical Low $0.78 Median $147.91 Typical High $269.15 | Professional | None | $0.78 | $147.91 | $269.15 |
Select Health Setting Facility Modifier None Typical Low $100.00 Median $181.97 Typical High $4,265.80 | Facility | None | $100.00 | $181.97 | $4,265.80 |
Select Health Setting Professional Modifier None Typical Low $162.18 Median $162.18 Typical High $162.18 | Professional | None | $162.18 | $162.18 | $162.18 |
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 $100.00 Median $154.88 Typical High $239.88 | Professional | None | $100.00 | $154.88 | $239.88 |
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 $52.48 Median $64.57 Typical High $97.72 | Professional | 52 · Reduced service | $52.48 | $64.57 | $97.72 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $20.89 Median $25.70 Typical High $38.90 | Professional | 53 · Discontinued | $20.89 | $25.70 | $38.90 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $79.43 Median $97.72 Typical High $144.54 | Professional | 54 · Surgery only | $79.43 | $97.72 | $144.54 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $15.85 Median $19.50 Typical High $29.51 | Professional | 55 · Aftercare only | $15.85 | $19.50 | $29.51 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $10.47 Median $12.88 Typical High $19.50 | Professional | 56 · Pre-op care only | $10.47 | $12.88 | $19.50 |
Aetna Setting Professional Modifier 78 · Unplanned return to OR Typical Low $74.13 Median $91.20 Typical High $134.90 | Professional | 78 · Unplanned return to OR | $74.13 | $91.20 | $134.90 |
Where Nevada sits
The same service costs 3.6 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· 32nd of 51
$170
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.