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 $239.88 Median $2,570.40 Typical High $5,011.87 | Facility | None | $239.88 | $2,570.40 | $5,011.87 |
Aetna Setting Professional Modifier None Typical Low $199.53 Median $316.23 Typical High $380.19 | Professional | None | $199.53 | $316.23 | $380.19 |
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 $190.55 Median $223.87 Typical High $316.23 | Professional | None | $190.55 | $223.87 | $316.23 |
Cigna Setting Facility Modifier None Typical Low $251.19 Median $309.03 Typical High $912.01 | Facility | None | $251.19 | $309.03 | $912.01 |
Cigna Setting Professional Modifier None Typical Low $199.53 Median $302.00 Typical High $457.09 | Professional | None | $199.53 | $302.00 | $457.09 |
Hometown Health Setting Professional Modifier None Typical Low $234.42 Median $316.23 Typical High $446.68 | Professional | None | $234.42 | $316.23 | $446.68 |
Hometown Health Setting Facility Modifier None Typical Low $251.19 Median $251.19 Typical High $251.19 | Facility | None | $251.19 | $251.19 | $251.19 |
Hometown Health Setting Professional Modifier None Typical Low $1.55 Median $269.15 Typical High $457.09 | Professional | None | $1.55 | $269.15 | $457.09 |
Select Health Setting Facility Modifier None Typical Low $177.83 Median $309.03 Typical High $4,265.80 | Facility | None | $177.83 | $309.03 | $4,265.80 |
Select Health Setting Professional Modifier None Typical Low $165.96 Median $309.03 Typical High $371.54 | Professional | None | $165.96 | $309.03 | $371.54 |
United Setting Facility Modifier None Typical Low $954.99 Median $1,318.26 Typical High $3,311.31 | Facility | None | $954.99 | $1,318.26 | $3,311.31 |
United Setting Professional Modifier None Typical Low $117.49 Median $288.40 Typical High $467.74 | Professional | None | $117.49 | $288.40 | $467.74 |
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 $100.00 Median $147.91 Typical High $190.55 | Professional | 52 · Reduced service | $100.00 | $147.91 | $190.55 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $40.74 Median $58.88 Typical High $75.86 | Professional | 53 · Discontinued | $40.74 | $58.88 | $75.86 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $151.36 Median $223.87 Typical High $281.84 | Professional | 54 · Surgery only | $151.36 | $223.87 | $281.84 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $30.20 Median $44.67 Typical High $57.54 | Professional | 55 · Aftercare only | $30.20 | $44.67 | $57.54 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $19.95 Median $29.51 Typical High $38.02 | Professional | 56 · Pre-op care only | $19.95 | $29.51 | $38.02 |
Aetna Setting Professional Modifier 78 · Unplanned return to OR Typical Low $141.25 Median $208.93 Typical High $263.03 | Professional | 78 · Unplanned return to OR | $141.25 | $208.93 | $263.03 |
Where Nevada sits
The same service costs 4.2 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· 35th of 51
$316
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.