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 $223.87 Median $2,570.40 Typical High $5,011.87 | Facility | None | $223.87 | $2,570.40 | $5,011.87 |
Aetna Setting Professional Modifier None Typical Low $199.53 Median $263.03 Typical High $309.03 | Professional | None | $199.53 | $263.03 | $309.03 |
Anthem BCBS Setting Facility Modifier None Typical Low $2,570.40 Median $3,801.89 Typical High $5,128.61 | Facility | None | $2,570.40 | $3,801.89 | $5,128.61 |
Anthem BCBS Setting Professional Modifier None Typical Low $208.93 Median $302.00 Typical High $467.74 | Professional | None | $208.93 | $302.00 | $467.74 |
Cigna Setting Facility Modifier None Typical Low $616.60 Median $1,230.27 Typical High $1,698.24 | Facility | None | $616.60 | $1,230.27 | $1,698.24 |
Cigna Setting Professional Modifier None Typical Low $169.82 Median $190.55 Typical High $371.54 | Professional | None | $169.82 | $190.55 | $371.54 |
Hometown Health Setting Professional Modifier None Typical Low $181.97 Median $275.42 Typical High $1,412.54 | Professional | None | $181.97 | $275.42 | $1,412.54 |
Hometown Health Setting Facility Modifier None Typical Low $1,174.90 Median $1,174.90 Typical High $1,174.90 | Facility | None | $1,174.90 | $1,174.90 | $1,174.90 |
Hometown Health Setting Professional Modifier None Typical Low $3.09 Median $281.84 Typical High $1,778.28 | Professional | None | $3.09 | $281.84 | $1,778.28 |
Select Health Setting Facility Modifier None Typical Low $186.21 Median $269.15 Typical High $4,265.80 | Facility | None | $186.21 | $269.15 | $4,265.80 |
Select Health Setting Professional Modifier None Typical Low $245.47 Median $245.47 Typical High $245.47 | Professional | None | $245.47 | $245.47 | $245.47 |
United Setting Facility Modifier None Typical Low $467.74 Median $724.44 Typical High $2,884.03 | Facility | None | $467.74 | $724.44 | $2,884.03 |
United Setting Professional Modifier None Typical Low $204.17 Median $257.04 Typical High $407.38 | Professional | None | $204.17 | $257.04 | $407.38 |
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 $100.00 Median $120.23 Typical High $144.54 | Professional | 52 · Reduced service | $100.00 | $120.23 | $144.54 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $39.81 Median $47.86 Typical High $57.54 | Professional | 53 · Discontinued | $39.81 | $47.86 | $57.54 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $151.36 Median $181.97 Typical High $218.78 | Professional | 54 · Surgery only | $151.36 | $181.97 | $218.78 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $30.20 Median $36.31 Typical High $43.65 | Professional | 55 · Aftercare only | $30.20 | $36.31 | $43.65 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $19.95 Median $23.99 Typical High $28.84 | Professional | 56 · Pre-op care only | $19.95 | $23.99 | $28.84 |
Aetna Setting Professional Modifier 78 · Unplanned return to OR Typical Low $141.25 Median $169.82 Typical High $204.17 | Professional | 78 · Unplanned return to OR | $141.25 | $169.82 | $204.17 |
Where Nevada sits
The same service costs 4.7 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· 39th of 51
$288
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.