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 $117.49 Median $131.83 Typical High $158.49 | Professional | None | $117.49 | $131.83 | $158.49 |
Ambetter Setting Professional Modifier None Typical Low $141.25 Median $141.25 Typical High $141.25 | Professional | None | $141.25 | $141.25 | $141.25 |
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 $114.82 Median $134.90 Typical High $218.78 | Professional | None | $114.82 | $134.90 | $218.78 |
Cigna Setting Facility Modifier None Typical Low $91.20 Median $112.20 Typical High $549.54 | Facility | None | $91.20 | $112.20 | $549.54 |
Cigna Setting Professional Modifier None Typical Low $134.90 Median $147.91 Typical High $229.09 | Professional | None | $134.90 | $147.91 | $229.09 |
Hometown Health Setting Professional Modifier None Typical Low $85.11 Median $128.82 Typical High $204.17 | Professional | None | $85.11 | $128.82 | $204.17 |
Hometown Health Setting Facility Modifier None Typical Low $91.20 Median $91.20 Typical High $91.20 | Facility | None | $91.20 | $91.20 | $91.20 |
Hometown Health Setting Professional Modifier None Typical Low $1.45 Median $134.90 Typical High $208.93 | Professional | None | $1.45 | $134.90 | $208.93 |
Select Health Setting Facility Modifier None Typical Low $107.15 Median $141.25 Typical High $4,265.80 | Facility | None | $107.15 | $141.25 | $4,265.80 |
Select Health Setting Professional Modifier None Typical Low $85.11 Median $125.89 Typical High $173.78 | Professional | None | $85.11 | $125.89 | $173.78 |
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 $109.65 Median $144.54 Typical High $218.78 | Professional | None | $109.65 | $144.54 | $218.78 |
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 $58.88 Median $66.07 Typical High $67.61 | Professional | 52 · Reduced service | $58.88 | $66.07 | $67.61 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $23.44 Median $26.92 Typical High $26.92 | Professional | 53 · Discontinued | $23.44 | $26.92 | $26.92 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $89.13 Median $100.00 Typical High $102.33 | Professional | 54 · Surgery only | $89.13 | $100.00 | $102.33 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $17.78 Median $19.95 Typical High $20.42 | Professional | 55 · Aftercare only | $17.78 | $19.95 | $20.42 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $11.75 Median $13.18 Typical High $13.49 | Professional | 56 · Pre-op care only | $11.75 | $13.18 | $13.49 |
Aetna Setting Professional Modifier 78 · Unplanned return to OR Typical Low $83.18 Median $93.33 Typical High $95.50 | Professional | 78 · Unplanned return to OR | $83.18 | $93.33 | $95.50 |
Where Nevada sits
The same service costs 4.2 times more in Alaska than in Florida. 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· 40th of 51
$141
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.