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 $302.00 Median $3,162.28 Typical High $5,011.87 | Facility | None | $302.00 | $3,162.28 | $5,011.87 |
Aetna Setting Professional Modifier None Typical Low $251.19 Median $316.23 Typical High $371.54 | Professional | None | $251.19 | $316.23 | $371.54 |
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 $239.88 Median $275.42 Typical High $398.11 | Professional | None | $239.88 | $275.42 | $398.11 |
Cigna Setting Facility Modifier None Typical Low $194.98 Median $239.88 Typical High $549.54 | Facility | None | $194.98 | $239.88 | $549.54 |
Cigna Setting Professional Modifier None Typical Low $234.42 Median $323.59 Typical High $501.19 | Professional | None | $234.42 | $323.59 | $501.19 |
Hometown Health Setting Professional Modifier None Typical Low $251.19 Median $338.84 Typical High $436.52 | Professional | None | $251.19 | $338.84 | $436.52 |
Hometown Health Setting Facility Modifier None Typical Low $194.98 Median $194.98 Typical High $194.98 | Facility | None | $194.98 | $194.98 | $194.98 |
Hometown Health Setting Professional Modifier None Typical Low $3.55 Median $288.40 Typical High $467.74 | Professional | None | $3.55 | $288.40 | $467.74 |
Select Health Setting Facility Modifier None Typical Low $208.93 Median $309.03 Typical High $4,265.80 | Facility | None | $208.93 | $309.03 | $4,265.80 |
Select Health Setting Professional Modifier None Typical Low $194.98 Median $309.03 Typical High $346.74 | Professional | None | $194.98 | $309.03 | $346.74 |
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 $234.42 Median $295.12 Typical High $478.63 | Professional | None | $234.42 | $295.12 | $478.63 |
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 $125.89 Median $151.36 Typical High $186.21 | Professional | 52 · Reduced service | $125.89 | $151.36 | $186.21 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $50.12 Median $60.26 Typical High $74.13 | Professional | 53 · Discontinued | $50.12 | $60.26 | $74.13 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $190.55 Median $223.87 Typical High $281.84 | Professional | 54 · Surgery only | $190.55 | $223.87 | $281.84 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $38.02 Median $44.67 Typical High $56.23 | Professional | 55 · Aftercare only | $38.02 | $44.67 | $56.23 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $25.12 Median $30.20 Typical High $37.15 | Professional | 56 · Pre-op care only | $25.12 | $30.20 | $37.15 |
Aetna Setting Professional Modifier 78 · Unplanned return to OR Typical Low $177.83 Median $208.93 Typical High $263.03 | Professional | 78 · Unplanned return to OR | $177.83 | $208.93 | $263.03 |
Where Nevada sits
The same service costs 5.2 times more in Alaska than in Utah. 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· 36th of 51
$316
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.