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 $251.19 Median $1,698.24 Typical High $4,365.16 | Facility | None | $251.19 | $1,698.24 | $4,365.16 |
Aetna Setting Professional Modifier None Typical Low $223.87 Median $251.19 Typical High $302.00 | Professional | None | $223.87 | $251.19 | $302.00 |
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 $208.93 Median $239.88 Typical High $346.74 | Professional | None | $208.93 | $239.88 | $346.74 |
Cigna Setting Facility Modifier None Typical Low $141.25 Median $177.83 Typical High $549.54 | Facility | None | $141.25 | $177.83 | $549.54 |
Cigna Setting Professional Modifier None Typical Low $204.17 Median $269.15 Typical High $398.11 | Professional | None | $204.17 | $269.15 | $398.11 |
Hometown Health Setting Professional Modifier None Typical Low $223.87 Median $269.15 Typical High $354.81 | Professional | None | $223.87 | $269.15 | $354.81 |
Hometown Health Setting Facility Modifier None Typical Low $141.25 Median $141.25 Typical High $141.25 | Facility | None | $141.25 | $141.25 | $141.25 |
Hometown Health Setting Professional Modifier None Typical Low $2.34 Median $213.80 Typical High $371.54 | Professional | None | $2.34 | $213.80 | $371.54 |
Select Health Setting Facility Modifier None Typical Low $186.21 Median $251.19 Typical High $4,265.80 | Facility | None | $186.21 | $251.19 | $4,265.80 |
Select Health Setting Professional Modifier None Typical Low $173.78 Median $251.19 Typical High $398.11 | Professional | None | $173.78 | $251.19 | $398.11 |
United Setting Facility Modifier None Typical Low $97.72 Median $245.47 Typical High $1,949.84 | Facility | None | $97.72 | $245.47 | $1,949.84 |
United Setting Professional Modifier None Typical Low $177.83 Median $229.09 Typical High $380.19 | Professional | None | $177.83 | $229.09 | $380.19 |
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 $112.20 Median $125.89 Typical High $147.91 | Professional | 52 · Reduced service | $112.20 | $125.89 | $147.91 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $44.67 Median $50.12 Typical High $60.26 | Professional | 53 · Discontinued | $44.67 | $50.12 | $60.26 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $165.96 Median $186.21 Typical High $223.87 | Professional | 54 · Surgery only | $165.96 | $186.21 | $223.87 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $33.11 Median $38.02 Typical High $44.67 | Professional | 55 · Aftercare only | $33.11 | $38.02 | $44.67 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $22.39 Median $25.12 Typical High $30.20 | Professional | 56 · Pre-op care only | $22.39 | $25.12 | $30.20 |
Aetna Setting Professional Modifier 78 · Unplanned return to OR Typical Low $154.88 Median $173.78 Typical High $208.93 | Professional | 78 · Unplanned return to OR | $154.88 | $173.78 | $208.93 |
Where Nevada sits
The same service costs 4.3 times more in Alaska than in Florida. 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· 39th of 51
$251
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.