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 $3,981.07 Typical High $5,248.07 | Facility | None | $302.00 | $3,981.07 | $5,248.07 |
Aetna Setting Professional Modifier None Typical Low $275.42 Median $302.00 Typical High $676.08 | Professional | None | $275.42 | $302.00 | $676.08 |
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 $263.03 Median $309.03 Typical High $436.52 | Professional | None | $263.03 | $309.03 | $436.52 |
Cigna Setting Facility Modifier None Typical Low $190.55 Median $234.42 Typical High $549.54 | Facility | None | $190.55 | $234.42 | $549.54 |
Cigna Setting Professional Modifier None Typical Low $323.59 Median $524.81 Typical High $812.83 | Professional | None | $323.59 | $524.81 | $812.83 |
Hometown Health Setting Professional Modifier None Typical Low $234.42 Median $691.83 Typical High $776.25 | Professional | None | $234.42 | $691.83 | $776.25 |
Hometown Health Setting Facility Modifier None Typical Low $190.55 Median $190.55 Typical High $190.55 | Facility | None | $190.55 | $190.55 | $190.55 |
Hometown Health Setting Professional Modifier None Typical Low $13.49 Median $281.84 Typical High $446.68 | Professional | None | $13.49 | $281.84 | $446.68 |
Select Health Setting Facility Modifier None Typical Low $234.42 Median $295.12 Typical High $4,265.80 | Facility | None | $234.42 | $295.12 | $4,265.80 |
Select Health Setting Professional Modifier None Typical Low $218.78 Median $309.03 Typical High $630.96 | Professional | None | $218.78 | $309.03 | $630.96 |
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 $275.42 Median $549.54 Typical High $831.76 | Professional | None | $275.42 | $549.54 | $831.76 |
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 $138.04 Median $151.36 Typical High $177.83 | Professional | 52 · Reduced service | $138.04 | $151.36 | $177.83 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $56.23 Median $60.26 Typical High $72.44 | Professional | 53 · Discontinued | $56.23 | $60.26 | $72.44 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $208.93 Median $223.87 Typical High $269.15 | Professional | 54 · Surgery only | $208.93 | $223.87 | $269.15 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $41.69 Median $45.71 Typical High $53.70 | Professional | 55 · Aftercare only | $41.69 | $45.71 | $53.70 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $27.54 Median $30.20 Typical High $35.48 | Professional | 56 · Pre-op care only | $27.54 | $30.20 | $35.48 |
Aetna Setting Professional Modifier 78 · Unplanned return to OR Typical Low $194.98 Median $208.93 Typical High $251.19 | Professional | 78 · Unplanned return to OR | $194.98 | $208.93 | $251.19 |
Where Nevada sits
The same service costs 5.0 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· 27th of 51
$447
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.