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 $2,238.72 Typical High $5,011.87 | Facility | None | $194.98 | $2,238.72 | $5,011.87 |
Aetna Setting Professional Modifier None Typical Low $194.98 Median $251.19 Typical High $263.03 | Professional | None | $194.98 | $251.19 | $263.03 |
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 $190.55 Median $218.78 Typical High $354.81 | Professional | None | $190.55 | $218.78 | $354.81 |
Cigna Setting Facility Modifier None Typical Low $478.63 Median $562.34 Typical High $776.25 | Facility | None | $478.63 | $562.34 | $776.25 |
Cigna Setting Professional Modifier None Typical Low $158.49 Median $190.55 Typical High $338.84 | Professional | None | $158.49 | $190.55 | $338.84 |
Hometown Health Setting Professional Modifier None Typical Low $120.23 Median $218.78 Typical High $467.74 | Professional | None | $120.23 | $218.78 | $467.74 |
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 $0.48 Median $269.15 Typical High $758.58 | Professional | None | $0.48 | $269.15 | $758.58 |
Select Health Setting Facility Modifier None Typical Low $181.97 Median $269.15 Typical High $4,265.80 | Facility | None | $181.97 | $269.15 | $4,265.80 |
Select Health Setting Professional Modifier None Typical Low $144.54 Median $223.87 Typical High $295.12 | Professional | None | $144.54 | $223.87 | $295.12 |
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 $154.88 Median $223.87 Typical High $346.74 | Professional | None | $154.88 | $223.87 | $346.74 |
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 $95.50 Median $112.20 Typical High $131.83 | Professional | 52 · Reduced service | $95.50 | $112.20 | $131.83 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $38.02 Median $44.67 Typical High $52.48 | Professional | 53 · Discontinued | $38.02 | $44.67 | $52.48 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $144.54 Median $169.82 Typical High $194.98 | Professional | 54 · Surgery only | $144.54 | $169.82 | $194.98 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $28.84 Median $33.88 Typical High $38.90 | Professional | 55 · Aftercare only | $28.84 | $33.88 | $38.90 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $19.05 Median $22.39 Typical High $26.30 | Professional | 56 · Pre-op care only | $19.05 | $22.39 | $26.30 |
Aetna Setting Professional Modifier 78 · Unplanned return to OR Typical Low $134.90 Median $158.49 Typical High $181.97 | Professional | 78 · Unplanned return to OR | $134.90 | $158.49 | $181.97 |
Where Nevada sits
The same service costs 4.3 times more in Alaska than in Kentucky. 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
$229
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.