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 $2,238.72 Typical High $5,011.87 | Facility | None | $117.49 | $2,238.72 | $5,011.87 |
Aetna Setting Professional Modifier None Typical Low $107.15 Median $144.54 Typical High $177.83 | Professional | None | $107.15 | $144.54 | $177.83 |
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 $109.65 Median $169.82 Typical High $275.42 | Professional | None | $109.65 | $169.82 | $275.42 |
Cigna Setting Facility Modifier None Typical Low $95.50 Median $117.49 Typical High $912.01 | Facility | None | $95.50 | $117.49 | $912.01 |
Cigna Setting Professional Modifier None Typical Low $97.72 Median $112.20 Typical High $223.87 | Professional | None | $97.72 | $112.20 | $223.87 |
Hometown Health Setting Professional Modifier None Typical Low $95.50 Median $141.25 Typical High $245.47 | Professional | None | $95.50 | $141.25 | $245.47 |
Hometown Health Setting Facility Modifier None Typical Low $95.50 Median $95.50 Typical High $95.50 | Facility | None | $95.50 | $95.50 | $95.50 |
Hometown Health Setting Professional Modifier None Typical Low $0.48 Median $141.25 Typical High $245.47 | Professional | None | $0.48 | $141.25 | $245.47 |
Select Health Setting Facility Modifier None Typical Low $100.00 Median $162.18 Typical High $4,265.80 | Facility | None | $100.00 | $162.18 | $4,265.80 |
Select Health Setting Professional Modifier None Typical Low $144.54 Median $144.54 Typical High $144.54 | Professional | None | $144.54 | $144.54 | $144.54 |
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 $112.20 Median $154.88 Typical High $245.47 | Professional | None | $112.20 | $154.88 | $245.47 |
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 $70.79 Typical High $87.10 | Professional | 52 · Reduced service | $53.70 | $70.79 | $87.10 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $21.38 Median $28.84 Typical High $35.48 | Professional | 53 · Discontinued | $21.38 | $28.84 | $35.48 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $79.43 Median $107.15 Typical High $131.83 | Professional | 54 · Surgery only | $79.43 | $107.15 | $131.83 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $15.85 Median $21.38 Typical High $26.30 | Professional | 55 · Aftercare only | $15.85 | $21.38 | $26.30 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $10.72 Median $14.13 Typical High $17.78 | Professional | 56 · Pre-op care only | $10.72 | $14.13 | $17.78 |
Aetna Setting Professional Modifier 78 · Unplanned return to OR Typical Low $74.13 Median $100.00 Typical High $123.03 | Professional | 78 · Unplanned return to OR | $74.13 | $100.00 | $123.03 |
Where Nevada sits
The same service costs 3.6 times more in Wisconsin than in Texas. 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· 38th of 51
$162
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.