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 $165.96 Median $2,238.72 Typical High $5,011.87 | Facility | None | $165.96 | $2,238.72 | $5,011.87 |
Aetna Setting Professional Modifier None Typical Low $138.04 Median $239.88 Typical High $331.13 | Professional | None | $138.04 | $239.88 | $331.13 |
Anthem BCBS Setting Facility Modifier None Typical Low $2,570.40 Median $3,801.89 Typical High $5,128.61 | Facility | None | $2,570.40 | $3,801.89 | $5,128.61 |
Anthem BCBS Setting Professional Modifier None Typical Low $131.83 Median $154.88 Typical High $218.78 | Professional | None | $131.83 | $154.88 | $218.78 |
Cigna Setting Facility Modifier None Typical Low $501.19 Median $630.96 Typical High $831.76 | Facility | None | $501.19 | $630.96 | $831.76 |
Cigna Setting Professional Modifier None Typical Low $120.23 Median $263.03 Typical High $398.11 | Professional | None | $120.23 | $263.03 | $398.11 |
Hometown Health Setting Professional Modifier None Typical Low $154.88 Median $295.12 Typical High $512.86 | Professional | None | $154.88 | $295.12 | $512.86 |
Hometown Health Setting Facility Modifier None Typical Low $562.34 Median $562.34 Typical High $562.34 | Facility | None | $562.34 | $562.34 | $562.34 |
Hometown Health Setting Professional Modifier None Typical Low $0.89 Median $177.83 Typical High $851.14 | Professional | None | $0.89 | $177.83 | $851.14 |
Select Health Setting Facility Modifier None Typical Low $117.49 Median $269.15 Typical High $4,265.80 | Facility | None | $117.49 | $269.15 | $4,265.80 |
Select Health Setting Professional Modifier None Typical Low $109.65 Median $223.87 Typical High $269.15 | Professional | None | $109.65 | $223.87 | $269.15 |
United Setting Facility Modifier None Typical Low $467.74 Median $724.44 Typical High $2,884.03 | Facility | None | $467.74 | $724.44 | $2,884.03 |
United Setting Professional Modifier None Typical Low $91.20 Median $239.88 Typical High $398.11 | Professional | None | $91.20 | $239.88 | $398.11 |
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 $69.18 Median $102.33 Typical High $165.96 | Professional | 52 · Reduced service | $69.18 | $102.33 | $165.96 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $27.54 Median $41.69 Typical High $66.07 | Professional | 53 · Discontinued | $27.54 | $41.69 | $66.07 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $104.71 Median $154.88 Typical High $251.19 | Professional | 54 · Surgery only | $104.71 | $154.88 | $251.19 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $20.89 Median $30.90 Typical High $50.12 | Professional | 55 · Aftercare only | $20.89 | $30.90 | $50.12 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $13.80 Median $20.89 Typical High $33.11 | Professional | 56 · Pre-op care only | $13.80 | $20.89 | $33.11 |
Aetna Setting Professional Modifier 78 · Unplanned return to OR Typical Low $97.72 Median $144.54 Typical High $234.42 | Professional | 78 · Unplanned return to OR | $97.72 | $144.54 | $234.42 |
Where Nevada sits
The same service costs 4.7 times more in Alaska than in Virginia. 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· 25th of 51
$282
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.