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 $158.49 Median $1,698.24 Typical High $4,365.16 | Facility | None | $158.49 | $1,698.24 | $4,365.16 |
Aetna Setting Professional Modifier None Typical Low $151.36 Median $158.49 Typical High $190.55 | Professional | None | $151.36 | $158.49 | $190.55 |
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 $144.54 Median $162.18 Typical High $234.42 | Professional | None | $144.54 | $162.18 | $234.42 |
Cigna Setting Facility Modifier None Typical Low $97.72 Median $123.03 Typical High $549.54 | Facility | None | $97.72 | $123.03 | $549.54 |
Cigna Setting Professional Modifier None Typical Low $125.89 Median $181.97 Typical High $288.40 | Professional | None | $125.89 | $181.97 | $288.40 |
Hometown Health Setting Professional Modifier None Typical Low $144.54 Median $169.82 Typical High $223.87 | Professional | None | $144.54 | $169.82 | $223.87 |
Hometown Health Setting Facility Modifier None Typical Low $97.72 Median $97.72 Typical High $97.72 | Facility | None | $97.72 | $97.72 | $97.72 |
Hometown Health Setting Professional Modifier None Typical Low $1.55 Median $147.91 Typical High $239.88 | Professional | None | $1.55 | $147.91 | $239.88 |
Select Health Setting Facility Modifier None Typical Low $128.82 Median $158.49 Typical High $4,265.80 | Facility | None | $128.82 | $158.49 | $4,265.80 |
Select Health Setting Professional Modifier None Typical Low $120.23 Median $169.82 Typical High $239.88 | Professional | None | $120.23 | $169.82 | $239.88 |
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 $54.95 Median $154.88 Typical High $263.03 | Professional | None | $54.95 | $154.88 | $263.03 |
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 $75.86 Median $79.43 Typical High $95.50 | Professional | 52 · Reduced service | $75.86 | $79.43 | $95.50 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $30.20 Median $31.62 Typical High $38.02 | Professional | 53 · Discontinued | $30.20 | $31.62 | $38.02 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $112.20 Median $120.23 Typical High $141.25 | Professional | 54 · Surgery only | $112.20 | $120.23 | $141.25 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $22.39 Median $23.99 Typical High $28.18 | Professional | 55 · Aftercare only | $22.39 | $23.99 | $28.18 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $15.14 Median $15.85 Typical High $19.05 | Professional | 56 · Pre-op care only | $15.14 | $15.85 | $19.05 |
Aetna Setting Professional Modifier 78 · Unplanned return to OR Typical Low $104.71 Median $112.20 Typical High $131.83 | Professional | 78 · Unplanned return to OR | $104.71 | $112.20 | $131.83 |
Where Nevada sits
The same service costs 4.6 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
$170
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.