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 $194.98 Median $1,698.24 Typical High $4,365.16 | Facility | None | $194.98 | $1,698.24 | $4,365.16 |
Aetna Setting Professional Modifier None Typical Low $173.78 Median $218.78 Typical High $257.04 | Professional | None | $173.78 | $218.78 | $257.04 |
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 $186.21 Median $263.03 Typical High $416.87 | Professional | None | $186.21 | $263.03 | $416.87 |
Cigna Setting Facility Modifier None Typical Low $398.11 Median $1,819.70 Typical High $2,630.27 | Facility | None | $398.11 | $1,819.70 | $2,630.27 |
Cigna Setting Professional Modifier None Typical Low $144.54 Median $169.82 Typical High $323.59 | Professional | None | $144.54 | $169.82 | $323.59 |
Hometown Health Setting Professional Modifier None Typical Low $154.88 Median $239.88 Typical High $2,187.76 | Professional | None | $154.88 | $239.88 | $2,187.76 |
Hometown Health Setting Facility Modifier None Typical Low $1,819.70 Median $1,819.70 Typical High $1,819.70 | Facility | None | $1,819.70 | $1,819.70 | $1,819.70 |
Hometown Health Setting Professional Modifier None Typical Low $2.51 Median $245.47 Typical High $2,691.53 | Professional | None | $2.51 | $245.47 | $2,691.53 |
Select Health Setting Facility Modifier None Typical Low $162.18 Median $239.88 Typical High $4,265.80 | Facility | None | $162.18 | $239.88 | $4,265.80 |
Select Health Setting Professional Modifier None Typical Low $213.80 Median $213.80 Typical High $213.80 | Professional | None | $213.80 | $213.80 | $213.80 |
United Setting Facility Modifier None Typical Low $954.99 Median $1,318.26 Typical High $3,311.31 | Facility | None | $954.99 | $1,318.26 | $3,311.31 |
United Setting Professional Modifier None Typical Low $177.83 Median $229.09 Typical High $363.08 | Professional | None | $177.83 | $229.09 | $363.08 |
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 $87.10 Median $107.15 Typical High $128.82 | Professional | 52 · Reduced service | $87.10 | $107.15 | $128.82 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $35.48 Median $42.66 Typical High $51.29 | Professional | 53 · Discontinued | $35.48 | $42.66 | $51.29 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $131.83 Median $162.18 Typical High $194.98 | Professional | 54 · Surgery only | $131.83 | $162.18 | $194.98 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $26.30 Median $32.36 Typical High $38.90 | Professional | 55 · Aftercare only | $26.30 | $32.36 | $38.90 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $17.38 Median $21.38 Typical High $25.70 | Professional | 56 · Pre-op care only | $17.38 | $21.38 | $25.70 |
Aetna Setting Professional Modifier 78 · Unplanned return to OR Typical Low $123.03 Median $151.36 Typical High $181.97 | Professional | 78 · Unplanned return to OR | $123.03 | $151.36 | $181.97 |
Where Nevada sits
The same service costs 4.4 times more in Alaska than in Utah. 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· 36th of 51
$257
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.