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 $912.01 Median $2,570.40 Typical High $6,165.95 | Facility | None | $912.01 | $2,570.40 | $6,165.95 |
Aetna Setting Professional Modifier None Typical Low $870.96 Median $870.96 Typical High $2,570.40 | Professional | None | $870.96 | $870.96 | $2,570.40 |
Anthem BCBS Setting Facility Modifier None Typical Low $2,754.23 Median $4,466.84 Typical High $5,754.40 | Facility | None | $2,754.23 | $4,466.84 | $5,754.40 |
Anthem BCBS Setting Professional Modifier None Typical Low $912.01 Median $1,096.48 Typical High $1,659.59 | Professional | None | $912.01 | $1,096.48 | $1,659.59 |
Cigna Setting Facility Modifier None Typical Low $616.60 Median $1,380.38 Typical High $1,949.84 | Facility | None | $616.60 | $1,380.38 | $1,949.84 |
Cigna Setting Professional Modifier None Typical Low $575.44 Median $794.33 Typical High $1,230.27 | Professional | None | $575.44 | $794.33 | $1,230.27 |
Hometown Health Setting Professional Modifier None Typical Low $12.88 Median $1,000.00 Typical High $1,318.26 | Professional | None | $12.88 | $1,000.00 | $1,318.26 |
Hometown Health Setting Facility Modifier None Typical Low $1,318.26 Median $1,318.26 Typical High $1,318.26 | Facility | None | $1,318.26 | $1,318.26 | $1,318.26 |
Hometown Health Setting Professional Modifier None Typical Low $10.96 Median $10.96 Typical High $1,258.93 | Professional | None | $10.96 | $10.96 | $1,258.93 |
Select Health Setting Facility Modifier None Typical Low $831.76 Median $831.76 Typical High $4,265.80 | Facility | None | $831.76 | $831.76 | $4,265.80 |
Select Health Setting Professional Modifier None Typical Low $870.96 Median $870.96 Typical High $870.96 | Professional | None | $870.96 | $870.96 | $870.96 |
United Setting Facility Modifier None Typical Low $954.99 Median $1,318.26 Typical High $3,311.31 | Facility | None | $954.99 | $1,318.26 | $3,311.31 |
United Setting Professional Modifier None Typical Low $707.95 Median $933.25 Typical High $1,412.54 | Professional | None | $707.95 | $933.25 | $1,412.54 |
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 $416.87 Median $436.52 Typical High $446.68 | Professional | 52 · Reduced service | $416.87 | $436.52 | $446.68 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $165.96 Median $173.78 Typical High $181.97 | Professional | 53 · Discontinued | $165.96 | $173.78 | $181.97 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $616.60 Median $645.65 Typical High $676.08 | Professional | 54 · Surgery only | $616.60 | $645.65 | $676.08 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $123.03 Median $128.82 Typical High $134.90 | Professional | 55 · Aftercare only | $123.03 | $128.82 | $134.90 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $83.18 Median $87.10 Typical High $91.20 | Professional | 56 · Pre-op care only | $83.18 | $87.10 | $91.20 |
Aetna Setting Professional Modifier 78 · Unplanned return to OR Typical Low $575.44 Median $602.56 Typical High $630.96 | Professional | 78 · Unplanned return to OR | $575.44 | $602.56 | $630.96 |
Where Nevada sits
The same service costs 7.1 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
$1,072
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.