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 $575.44 Median $2,238.72 Typical High $5,011.87 | Facility | None | $575.44 | $2,238.72 | $5,011.87 |
Aetna Setting Professional Modifier None Typical Low $562.34 Median $707.95 Typical High $1,047.13 | Professional | None | $562.34 | $707.95 | $1,047.13 |
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 $588.84 Median $812.83 Typical High $1,174.90 | Professional | None | $588.84 | $812.83 | $1,174.90 |
Cigna Setting Facility Modifier None Typical Low $501.19 Median $1,174.90 Typical High $1,698.24 | Facility | None | $501.19 | $1,174.90 | $1,698.24 |
Cigna Setting Professional Modifier None Typical Low $524.81 Median $645.65 Typical High $1,000.00 | Professional | None | $524.81 | $645.65 | $1,000.00 |
Hometown Health Setting Professional Modifier None Typical Low $588.84 Median $851.14 Typical High $1,288.25 | Professional | None | $588.84 | $851.14 | $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 $4.37 Median $794.33 Typical High $1,778.28 | Professional | None | $4.37 | $794.33 | $1,778.28 |
Select Health Setting Facility Modifier None Typical Low $537.03 Median $776.25 Typical High $4,265.80 | Facility | None | $537.03 | $776.25 | $4,265.80 |
Select Health Setting Professional Modifier None Typical Low $562.34 Median $562.34 Typical High $562.34 | Professional | None | $562.34 | $562.34 | $562.34 |
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 $524.81 Median $707.95 Typical High $1,096.48 | Professional | None | $524.81 | $707.95 | $1,096.48 |
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 $275.42 Median $309.03 Typical High $371.54 | Professional | 52 · Reduced service | $275.42 | $309.03 | $371.54 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $112.20 Median $125.89 Typical High $147.91 | Professional | 53 · Discontinued | $112.20 | $125.89 | $147.91 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $416.87 Median $467.74 Typical High $549.54 | Professional | 54 · Surgery only | $416.87 | $467.74 | $549.54 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $83.18 Median $93.33 Typical High $109.65 | Professional | 55 · Aftercare only | $83.18 | $93.33 | $109.65 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $56.23 Median $63.10 Typical High $74.13 | Professional | 56 · Pre-op care only | $56.23 | $63.10 | $74.13 |
Aetna Setting Professional Modifier 78 · Unplanned return to OR Typical Low $389.05 Median $436.52 Typical High $512.86 | Professional | 78 · Unplanned return to OR | $389.05 | $436.52 | $512.86 |
Where Nevada sits
The same service costs 4.2 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· 33rd of 51
$759
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.