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 $338.84 Median $2,238.72 Typical High $5,011.87 | Facility | None | $338.84 | $2,238.72 | $5,011.87 |
Aetna Setting Professional Modifier None Typical Low $302.00 Median $338.84 Typical High $457.09 | Professional | None | $302.00 | $338.84 | $457.09 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $223.87 Median $239.88 Typical High $281.84 | Professional | 54 · Surgery only | $223.87 | $239.88 | $281.84 |
Ambetter Setting Professional Modifier None Typical Low $275.42 Median $275.42 Typical High $316.23 | Professional | None | $275.42 | $275.42 | $316.23 |
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 $302.00 Median $346.74 Typical High $489.78 | Professional | None | $302.00 | $346.74 | $489.78 |
Cigna Setting Facility Modifier None Typical Low $316.23 Median $398.11 Typical High $676.08 | Facility | None | $316.23 | $398.11 | $676.08 |
Cigna Setting Professional Modifier None Typical Low $177.83 Median $363.08 Typical High $562.34 | Professional | None | $177.83 | $363.08 | $562.34 |
Hometown Health Setting Professional Modifier None Typical Low $331.13 Median $363.08 Typical High $512.86 | Professional | None | $331.13 | $363.08 | $512.86 |
Hometown Health Setting Facility Modifier None Typical Low $316.23 Median $316.23 Typical High $316.23 | Facility | None | $316.23 | $316.23 | $316.23 |
Hometown Health Setting Professional Modifier None Typical Low $3.80 Median $407.38 Typical High $501.19 | Professional | None | $3.80 | $407.38 | $501.19 |
Select Health Setting Facility Modifier None Typical Low $275.42 Median $331.13 Typical High $4,265.80 | Facility | None | $275.42 | $331.13 | $4,265.80 |
Select Health Setting Professional Modifier None Typical Low $257.04 Median $346.74 Typical High $501.19 | Professional | None | $257.04 | $346.74 | $501.19 |
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 $316.23 Typical High $524.81 | Professional | None | $239.88 | $316.23 | $524.81 |
5 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 $158.49 Median $169.82 Typical High $204.17 | Professional | 52 · Reduced service | $158.49 | $169.82 | $204.17 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $63.10 Median $67.61 Typical High $81.28 | Professional | 53 · Discontinued | $63.10 | $67.61 | $81.28 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $47.86 Median $51.29 Typical High $60.26 | Professional | 55 · Aftercare only | $47.86 | $51.29 | $60.26 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $31.62 Median $33.88 Typical High $40.74 | Professional | 56 · Pre-op care only | $31.62 | $33.88 | $40.74 |
Aetna Setting Professional Modifier 78 · Unplanned return to OR Typical Low $223.87 Median $239.88 Typical High $281.84 | Professional | 78 · Unplanned return to OR | $223.87 | $239.88 | $281.84 |
Where Nevada sits
The same service costs 5.8 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· 32nd of 51
$355
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.