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 $154.88 Median $1,698.24 Typical High $4,365.16 | Facility | None | $154.88 | $1,698.24 | $4,365.16 |
Aetna Setting Professional Modifier None Typical Low $154.88 Median $234.42 Typical High $234.42 | Professional | None | $154.88 | $234.42 | $234.42 |
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 $154.88 Median $177.83 Typical High $288.40 | Professional | None | $154.88 | $177.83 | $288.40 |
Cigna Setting Facility Modifier None Typical Low $398.11 Median $549.54 Typical High $758.58 | Facility | None | $398.11 | $549.54 | $758.58 |
Cigna Setting Professional Modifier None Typical Low $125.89 Median $208.93 Typical High $363.08 | Professional | None | $125.89 | $208.93 | $363.08 |
Hometown Health Setting Professional Modifier None Typical Low $109.65 Median $194.98 Typical High $446.68 | Professional | None | $109.65 | $194.98 | $446.68 |
Hometown Health Setting Facility Modifier None Typical Low $501.19 Median $501.19 Typical High $501.19 | Facility | None | $501.19 | $501.19 | $501.19 |
Hometown Health Setting Professional Modifier None Typical Low $2.51 Median $204.17 Typical High $758.58 | Professional | None | $2.51 | $204.17 | $758.58 |
Select Health Setting Facility Modifier None Typical Low $134.90 Median $245.47 Typical High $4,265.80 | Facility | None | $134.90 | $245.47 | $4,265.80 |
Select Health Setting Professional Modifier None Typical Low $107.15 Median $199.53 Typical High $234.42 | Professional | None | $107.15 | $199.53 | $234.42 |
United Setting Facility Modifier None Typical Low $302.00 Median $512.86 Typical High $2,137.96 | Facility | None | $302.00 | $512.86 | $2,137.96 |
United Setting Professional Modifier None Typical Low $138.04 Median $223.87 Typical High $371.54 | Professional | None | $138.04 | $223.87 | $371.54 |
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 $75.86 Median $104.71 Typical High $117.49 | Professional | 52 · Reduced service | $75.86 | $104.71 | $117.49 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $30.90 Median $41.69 Typical High $47.86 | Professional | 53 · Discontinued | $30.90 | $41.69 | $47.86 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $114.82 Median $154.88 Typical High $177.83 | Professional | 54 · Surgery only | $114.82 | $154.88 | $177.83 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $22.91 Median $30.90 Typical High $35.48 | Professional | 55 · Aftercare only | $22.91 | $30.90 | $35.48 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $15.49 Median $20.89 Typical High $23.44 | Professional | 56 · Pre-op care only | $15.49 | $20.89 | $23.44 |
Aetna Setting Professional Modifier 78 · Unplanned return to OR Typical Low $107.15 Median $144.54 Typical High $165.96 | Professional | 78 · Unplanned return to OR | $107.15 | $144.54 | $165.96 |
Where Nevada sits
The same service costs 4.2 times more in Alaska than in Virginia. 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
$214
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.