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 $776.25 Median $2,570.40 Typical High $5,011.87 | Facility | None | $776.25 | $2,570.40 | $5,011.87 |
Aetna Setting Professional Modifier None Typical Low $741.31 Median $912.01 Typical High $1,288.25 | Professional | None | $741.31 | $912.01 | $1,288.25 |
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 $794.33 Median $1,071.52 Typical High $1,513.56 | Professional | None | $794.33 | $1,071.52 | $1,513.56 |
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 $707.95 Median $851.14 Typical High $1,318.26 | Professional | None | $707.95 | $851.14 | $1,318.26 |
Hometown Health Setting Professional Modifier None Typical Low $12.30 Median $1,096.48 Typical High $1,479.11 | Professional | None | $12.30 | $1,096.48 | $1,479.11 |
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 $9.33 Median $1,047.13 Typical High $1,778.28 | Professional | None | $9.33 | $1,047.13 | $1,778.28 |
Select Health Setting Facility Modifier None Typical Low $691.83 Median $1,000.00 Typical High $4,265.80 | Facility | None | $691.83 | $1,000.00 | $4,265.80 |
Select Health Setting Professional Modifier None Typical Low $724.44 Median $724.44 Typical High $724.44 | Professional | None | $724.44 | $724.44 | $724.44 |
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 $812.83 Median $1,000.00 Typical High $1,513.56 | Professional | None | $812.83 | $1,000.00 | $1,513.56 |
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 $371.54 Median $416.87 Typical High $467.74 | Professional | 52 · Reduced service | $371.54 | $416.87 | $467.74 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $147.91 Median $165.96 Typical High $190.55 | Professional | 53 · Discontinued | $147.91 | $165.96 | $190.55 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $562.34 Median $630.96 Typical High $707.95 | Professional | 54 · Surgery only | $562.34 | $630.96 | $707.95 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $112.20 Median $125.89 Typical High $141.25 | Professional | 55 · Aftercare only | $112.20 | $125.89 | $141.25 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $74.13 Median $83.18 Typical High $95.50 | Professional | 56 · Pre-op care only | $74.13 | $83.18 | $95.50 |
Aetna Setting Professional Modifier 78 · Unplanned return to OR Typical Low $524.81 Median $588.84 Typical High $660.69 | Professional | 78 · Unplanned return to OR | $524.81 | $588.84 | $660.69 |
Where Nevada sits
The same service costs 4.5 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
$1,000
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.