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 $537.03 Median $2,570.40 Typical High $5,011.87 | Facility | None | $537.03 | $2,570.40 | $5,011.87 |
Aetna Setting Professional Modifier None Typical Low $501.19 Median $616.60 Typical High $870.96 | Professional | None | $501.19 | $616.60 | $870.96 |
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 $549.54 Median $741.31 Typical High $1,071.52 | Professional | None | $549.54 | $741.31 | $1,071.52 |
Cigna Setting Facility Modifier None Typical Low $616.60 Median $1,230.27 Typical High $1,698.24 | Facility | None | $616.60 | $1,230.27 | $1,698.24 |
Cigna Setting Professional Modifier None Typical Low $489.78 Median $588.84 Typical High $912.01 | Professional | None | $489.78 | $588.84 | $912.01 |
Hometown Health Setting Professional Modifier None Typical Low $549.54 Median $794.33 Typical High $1,288.25 | Professional | None | $549.54 | $794.33 | $1,288.25 |
Hometown Health Setting Facility Modifier None Typical Low $1,174.90 Median $1,174.90 Typical High $1,174.90 | Facility | None | $1,174.90 | $1,174.90 | $1,174.90 |
Hometown Health Setting Professional Modifier None Typical Low $4.47 Median $741.31 Typical High $1,778.28 | Professional | None | $4.47 | $741.31 | $1,778.28 |
Select Health Setting Facility Modifier None Typical Low $501.19 Median $707.95 Typical High $4,265.80 | Facility | None | $501.19 | $707.95 | $4,265.80 |
Select Health Setting Professional Modifier None Typical Low $524.81 Median $524.81 Typical High $524.81 | Professional | None | $524.81 | $524.81 | $524.81 |
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 $501.19 Median $660.69 Typical High $1,000.00 | Professional | None | $501.19 | $660.69 | $1,000.00 |
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 $257.04 Median $288.40 Typical High $338.84 | Professional | 52 · Reduced service | $257.04 | $288.40 | $338.84 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $102.33 Median $114.82 Typical High $134.90 | Professional | 53 · Discontinued | $102.33 | $114.82 | $134.90 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $389.05 Median $436.52 Typical High $501.19 | Professional | 54 · Surgery only | $389.05 | $436.52 | $501.19 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $77.62 Median $87.10 Typical High $100.00 | Professional | 55 · Aftercare only | $77.62 | $87.10 | $100.00 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $51.29 Median $57.54 Typical High $67.61 | Professional | 56 · Pre-op care only | $51.29 | $57.54 | $67.61 |
Aetna Setting Professional Modifier 78 · Unplanned return to OR Typical Low $363.08 Median $407.38 Typical High $467.74 | Professional | 78 · Unplanned return to OR | $363.08 | $407.38 | $467.74 |
Where Nevada sits
The same service costs 4.3 times more in Alaska than in Texas. 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· 32nd of 51
$708
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.