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 $123.03 Median $134.90 Typical High $158.49 | Professional | None | $123.03 | $134.90 | $158.49 |
Ambetter Setting Professional Modifier None Typical Low $120.23 Median $141.25 Typical High $154.88 | Professional | None | $120.23 | $141.25 | $154.88 |
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 $120.23 Median $138.04 Typical High $223.87 | Professional | None | $120.23 | $138.04 | $223.87 |
Cigna Setting Facility Modifier None Typical Low $75.86 Median $95.50 Typical High $912.01 | Facility | None | $75.86 | $95.50 | $912.01 |
Cigna Setting Professional Modifier None Typical Low $109.65 Median $131.83 Typical High $213.80 | Professional | None | $109.65 | $131.83 | $213.80 |
Hometown Health Setting Professional Modifier None Typical Low $89.13 Median $128.82 Typical High $218.78 | Professional | None | $89.13 | $128.82 | $218.78 |
Hometown Health Setting Facility Modifier None Typical Low $79.43 Median $79.43 Typical High $79.43 | Facility | None | $79.43 | $79.43 | $79.43 |
Hometown Health Setting Professional Modifier None Typical Low $1.51 Median $120.23 Typical High $229.09 | Professional | None | $1.51 | $120.23 | $229.09 |
Select Health Setting Facility Modifier None Typical Low $104.71 Median $154.88 Typical High $4,265.80 | Facility | None | $104.71 | $154.88 | $4,265.80 |
Select Health Setting Professional Modifier None Typical Low $85.11 Median $138.04 Typical High $173.78 | Professional | None | $85.11 | $138.04 | $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 $123.03 Median $158.49 Typical High $229.09 | Professional | None | $123.03 | $158.49 | $229.09 |
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 $63.10 Median $69.18 Typical High $79.43 | Professional | 52 · Reduced service | $63.10 | $69.18 | $79.43 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $25.12 Median $27.54 Typical High $31.62 | Professional | 53 · Discontinued | $25.12 | $27.54 | $31.62 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $93.33 Median $102.33 Typical High $117.49 | Professional | 54 · Surgery only | $93.33 | $102.33 | $117.49 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $18.62 Median $20.42 Typical High $23.99 | Professional | 55 · Aftercare only | $18.62 | $20.42 | $23.99 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $12.59 Median $13.80 Typical High $15.85 | Professional | 56 · Pre-op care only | $12.59 | $13.80 | $15.85 |
Aetna Setting Professional Modifier 78 · Unplanned return to OR Typical Low $87.10 Median $95.50 Typical High $109.65 | Professional | 78 · Unplanned return to OR | $87.10 | $95.50 | $109.65 |
Where Nevada sits
The same service costs 3.9 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· 41st of 51
$148
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.