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 $1,698.24 Typical High $4,365.16 | Facility | None | $302.00 | $1,698.24 | $4,365.16 |
Aetna Setting Professional Modifier None Typical Low $257.04 Median $302.00 Typical High $354.81 | Professional | None | $257.04 | $302.00 | $354.81 |
Anthem BCBS Setting Facility Modifier None Typical Low $2,754.23 Median $4,466.84 Typical High $5,754.40 | Facility | None | $2,754.23 | $4,466.84 | $5,754.40 |
Anthem BCBS Setting Professional Modifier None Typical Low $245.47 Median $288.40 Typical High $407.38 | Professional | None | $245.47 | $288.40 | $407.38 |
Cigna Setting Facility Modifier None Typical Low $181.97 Median $229.09 Typical High $489.78 | Facility | None | $181.97 | $229.09 | $489.78 |
Cigna Setting Professional Modifier None Typical Low $309.03 Median $467.74 Typical High $676.08 | Professional | None | $309.03 | $467.74 | $676.08 |
Hometown Health Setting Professional Modifier None Typical Low $213.80 Median $588.84 Typical High $660.69 | Professional | None | $213.80 | $588.84 | $660.69 |
Hometown Health Setting Facility Modifier None Typical Low $181.97 Median $181.97 Typical High $181.97 | Facility | None | $181.97 | $181.97 | $181.97 |
Hometown Health Setting Professional Modifier None Typical Low $8.91 Median $275.42 Typical High $446.68 | Professional | None | $8.91 | $275.42 | $446.68 |
Select Health Setting Facility Modifier None Typical Low $213.80 Median $295.12 Typical High $4,265.80 | Facility | None | $213.80 | $295.12 | $4,265.80 |
Select Health Setting Professional Modifier None Typical Low $199.53 Median $295.12 Typical High $575.44 | Professional | None | $199.53 | $295.12 | $575.44 |
United Setting Facility Modifier None Typical Low $1,174.90 Median $1,698.24 Typical High $4,073.80 | Facility | None | $1,174.90 | $1,698.24 | $4,073.80 |
United Setting Professional Modifier None Typical Low $263.03 Median $478.63 Typical High $707.95 | Professional | None | $263.03 | $478.63 | $707.95 |
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 $128.82 Median $151.36 Typical High $177.83 | Professional | 52 · Reduced service | $128.82 | $151.36 | $177.83 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $51.29 Median $60.26 Typical High $70.79 | Professional | 53 · Discontinued | $51.29 | $60.26 | $70.79 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $194.98 Median $223.87 Typical High $269.15 | Professional | 54 · Surgery only | $194.98 | $223.87 | $269.15 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $38.90 Median $44.67 Typical High $53.70 | Professional | 55 · Aftercare only | $38.90 | $44.67 | $53.70 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $25.70 Median $30.20 Typical High $35.48 | Professional | 56 · Pre-op care only | $25.70 | $30.20 | $35.48 |
Aetna Setting Professional Modifier 78 · Unplanned return to OR Typical Low $181.97 Median $208.93 Typical High $251.19 | Professional | 78 · Unplanned return to OR | $181.97 | $208.93 | $251.19 |
Where Nevada sits
The same service costs 5.1 times more in Wyoming 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· 29th of 51
$457
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.