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 $288.40 Median $1,698.24 Typical High $4,365.16 | Facility | None | $288.40 | $1,698.24 | $4,365.16 |
Aetna Setting Professional Modifier None Typical Low $239.88 Median $309.03 Typical High $380.19 | Professional | None | $239.88 | $309.03 | $380.19 |
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 $229.09 Median $263.03 Typical High $380.19 | Professional | None | $229.09 | $263.03 | $380.19 |
Cigna Setting Facility Modifier None Typical Low $204.17 Median $257.04 Typical High $549.54 | Facility | None | $204.17 | $257.04 | $549.54 |
Cigna Setting Professional Modifier None Typical Low $245.47 Median $323.59 Typical High $512.86 | Professional | None | $245.47 | $323.59 | $512.86 |
Hometown Health Setting Professional Modifier None Typical Low $257.04 Median $323.59 Typical High $416.87 | Professional | None | $257.04 | $323.59 | $416.87 |
Hometown Health Setting Facility Modifier None Typical Low $204.17 Median $204.17 Typical High $204.17 | Facility | None | $204.17 | $204.17 | $204.17 |
Hometown Health Setting Professional Modifier None Typical Low $6.92 Median $302.00 Typical High $446.68 | Professional | None | $6.92 | $302.00 | $446.68 |
Select Health Setting Facility Modifier None Typical Low $199.53 Median $295.12 Typical High $4,265.80 | Facility | None | $199.53 | $295.12 | $4,265.80 |
Select Health Setting Professional Modifier None Typical Low $186.21 Median $295.12 Typical High $371.54 | Professional | None | $186.21 | $295.12 | $371.54 |
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 $239.88 Median $346.74 Typical High $512.86 | Professional | None | $239.88 | $346.74 | $512.86 |
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 $120.23 Median $154.88 Typical High $181.97 | Professional | 52 · Reduced service | $120.23 | $154.88 | $181.97 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $47.86 Median $61.66 Typical High $72.44 | Professional | 53 · Discontinued | $47.86 | $61.66 | $72.44 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $181.97 Median $229.09 Typical High $275.42 | Professional | 54 · Surgery only | $181.97 | $229.09 | $275.42 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $36.31 Median $45.71 Typical High $54.95 | Professional | 55 · Aftercare only | $36.31 | $45.71 | $54.95 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $23.99 Median $30.90 Typical High $36.31 | Professional | 56 · Pre-op care only | $23.99 | $30.90 | $36.31 |
Aetna Setting Professional Modifier 78 · Unplanned return to OR Typical Low $169.82 Median $213.80 Typical High $257.04 | Professional | 78 · Unplanned return to OR | $169.82 | $213.80 | $257.04 |
Where Nevada sits
The same service costs 4.2 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· 38th of 51
$324
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.