How much rates vary
Facilitymedian $1,738 · 10th to 90th $562 to $4,467Professionalmedian $891 · 10th to 90th $692 to $1,349
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 $724.44 Median $2,570.40 Typical High $5,011.87 | Facility | None | $724.44 | $2,570.40 | $5,011.87 |
Aetna Setting Professional Modifier None Typical Low $691.83 Median $831.76 Typical High $1,258.93 | Professional | None | $691.83 | $831.76 | $1,258.93 |
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 $741.31 Median $1,000.00 Typical High $1,412.54 | Professional | None | $741.31 | $1,000.00 | $1,412.54 |
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 $660.69 Median $794.33 Typical High $1,230.27 | Professional | None | $660.69 | $794.33 | $1,230.27 |
Hometown Health Setting Professional Modifier None Typical Low $707.95 Median $1,000.00 Typical High $1,412.54 | Professional | None | $707.95 | $1,000.00 | $1,412.54 |
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 $7.94 Median $977.24 Typical High $1,778.28 | Professional | None | $7.94 | $977.24 | $1,778.28 |
Select Health Setting Facility Modifier None Typical Low $645.65 Median $912.01 Typical High $4,265.80 | Facility | None | $645.65 | $912.01 | $4,265.80 |
Select Health Setting Professional Modifier None Typical Low $676.08 Median $676.08 Typical High $676.08 | Professional | None | $676.08 | $676.08 | $676.08 |
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 $724.44 Median $912.01 Typical High $1,380.38 | Professional | None | $724.44 | $912.01 | $1,380.38 |
7 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 $346.74 Median $389.05 Typical High $436.52 | Professional | 52 · Reduced service | $346.74 | $389.05 | $436.52 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $138.04 Median $154.88 Typical High $173.78 | Professional | 53 · Discontinued | $138.04 | $154.88 | $173.78 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $512.86 Median $588.84 Typical High $660.69 | Professional | 54 · Surgery only | $512.86 | $588.84 | $660.69 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $104.71 Median $117.49 Typical High $131.83 | Professional | 55 · Aftercare only | $104.71 | $117.49 | $131.83 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $69.18 Median $77.62 Typical High $87.10 | Professional | 56 · Pre-op care only | $69.18 | $77.62 | $87.10 |
Aetna Setting Professional Modifier 78 · Unplanned return to OR Typical Low $489.78 Median $549.54 Typical High $616.60 | Professional | 78 · Unplanned return to OR | $489.78 | $549.54 | $616.60 |
Ambetter Setting Professional Modifier 79 · Unrelated procedure after surgery Typical Low $1,096.48 Median $1,096.48 Typical High $1,096.48 | Professional | 79 · Unrelated procedure after surgery | $1,096.48 | $1,096.48 | $1,096.48 |
Where Nevada sits
The same service costs 4.4 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· 35th of 51
$933
AK $3,090TX $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.