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 $616.60 Median $2,570.40 Typical High $5,011.87 | Facility | None | $616.60 | $2,570.40 | $5,011.87 |
Aetna Setting Professional Modifier None Typical Low $588.84 Median $724.44 Typical High $954.99 | Professional | None | $588.84 | $724.44 | $954.99 |
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 $630.96 Median $870.96 Typical High $1,202.26 | Professional | None | $630.96 | $870.96 | $1,202.26 |
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 $537.03 Median $676.08 Typical High $1,023.29 | Professional | None | $537.03 | $676.08 | $1,023.29 |
Hometown Health Setting Professional Modifier None Typical Low $616.60 Median $870.96 Typical High $1,288.25 | Professional | None | $616.60 | $870.96 | $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 $6.61 Median $831.76 Typical High $1,778.28 | Professional | None | $6.61 | $831.76 | $1,778.28 |
Select Health Setting Facility Modifier None Typical Low $562.34 Median $794.33 Typical High $4,265.80 | Facility | None | $562.34 | $794.33 | $4,265.80 |
Select Health Setting Professional Modifier None Typical Low $588.84 Median $588.84 Typical High $588.84 | Professional | None | $588.84 | $588.84 | $588.84 |
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 $549.54 Median $758.58 Typical High $1,148.15 | Professional | None | $549.54 | $758.58 | $1,148.15 |
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 $295.12 Median $331.13 Typical High $380.19 | Professional | 52 · Reduced service | $295.12 | $331.13 | $380.19 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $120.23 Median $131.83 Typical High $151.36 | Professional | 53 · Discontinued | $120.23 | $131.83 | $151.36 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $446.68 Median $489.78 Typical High $562.34 | Professional | 54 · Surgery only | $446.68 | $489.78 | $562.34 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $89.13 Median $97.72 Typical High $112.20 | Professional | 55 · Aftercare only | $89.13 | $97.72 | $112.20 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $58.88 Median $66.07 Typical High $75.86 | Professional | 56 · Pre-op care only | $58.88 | $66.07 | $75.86 |
Aetna Setting Professional Modifier 78 · Unplanned return to OR Typical Low $416.87 Median $457.09 Typical High $524.81 | Professional | 78 · Unplanned return to OR | $416.87 | $457.09 | $524.81 |
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· 32nd of 51
$794
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.