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 $190.55 Median $2,238.72 Typical High $5,011.87 | Facility | None | $190.55 | $2,238.72 | $5,011.87 |
Aetna Setting Professional Modifier None Typical Low $162.18 Median $251.19 Typical High $346.74 | Professional | None | $162.18 | $251.19 | $346.74 |
Ambetter Setting Professional Modifier None Typical Low $275.42 Median $275.42 Typical High $275.42 | Professional | None | $275.42 | $275.42 | $275.42 |
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 $151.36 Median $177.83 Typical High $251.19 | Professional | None | $151.36 | $177.83 | $251.19 |
Cigna Setting Facility Modifier None Typical Low $213.80 Median $269.15 Typical High $549.54 | Facility | None | $213.80 | $269.15 | $549.54 |
Cigna Setting Professional Modifier None Typical Low $131.83 Median $229.09 Typical High $407.38 | Professional | None | $131.83 | $229.09 | $407.38 |
Hometown Health Setting Professional Modifier None Typical Low $173.78 Median $269.15 Typical High $389.05 | Professional | None | $173.78 | $269.15 | $389.05 |
Hometown Health Setting Facility Modifier None Typical Low $213.80 Median $213.80 Typical High $213.80 | Facility | None | $213.80 | $213.80 | $213.80 |
Hometown Health Setting Professional Modifier None Typical Low $1.55 Median $199.53 Typical High $416.87 | Professional | None | $1.55 | $199.53 | $416.87 |
Select Health Setting Facility Modifier None Typical Low $134.90 Median $275.42 Typical High $4,265.80 | Facility | None | $134.90 | $275.42 | $4,265.80 |
Select Health Setting Professional Modifier None Typical Low $125.89 Median $251.19 Typical High $281.84 | Professional | None | $125.89 | $251.19 | $281.84 |
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 $120.23 Median $251.19 Typical High $389.05 | Professional | None | $120.23 | $251.19 | $389.05 |
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 $79.43 Median $117.49 Typical High $173.78 | Professional | 52 · Reduced service | $79.43 | $117.49 | $173.78 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $32.36 Median $46.77 Typical High $69.18 | Professional | 53 · Discontinued | $32.36 | $46.77 | $69.18 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $120.23 Median $177.83 Typical High $263.03 | Professional | 54 · Surgery only | $120.23 | $177.83 | $263.03 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $23.99 Median $35.48 Typical High $52.48 | Professional | 55 · Aftercare only | $23.99 | $35.48 | $52.48 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $16.22 Median $23.44 Typical High $34.67 | Professional | 56 · Pre-op care only | $16.22 | $23.44 | $34.67 |
Aetna Setting Professional Modifier 78 · Unplanned return to OR Typical Low $112.20 Median $165.96 Typical High $245.47 | Professional | 78 · Unplanned return to OR | $112.20 | $165.96 | $245.47 |
Where Nevada sits
The same service costs 3.8 times more in Wyoming than in Kentucky. 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· 30th of 51
$275
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.