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 $691.83 Median $2,238.72 Typical High $5,011.87 | Facility | None | $691.83 | $2,238.72 | $5,011.87 |
Aetna Setting Professional Modifier None Typical Low $660.69 Median $758.58 Typical High $831.76 | Professional | None | $660.69 | $758.58 | $831.76 |
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 $707.95 Median $954.99 Typical High $1,318.26 | Professional | None | $707.95 | $954.99 | $1,318.26 |
Cigna Setting Facility Modifier None Typical Low $691.83 Median $1,380.38 Typical High $1,949.84 | Facility | None | $691.83 | $1,380.38 | $1,949.84 |
Cigna Setting Professional Modifier None Typical Low $602.56 Median $724.44 Typical High $1,148.15 | Professional | None | $602.56 | $724.44 | $1,148.15 |
Hometown Health Setting Professional Modifier None Typical Low $707.95 Median $1,000.00 Typical High $1,513.56 | Professional | None | $707.95 | $1,000.00 | $1,513.56 |
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 $5.50 Median $977.24 Typical High $1,949.84 | Professional | None | $5.50 | $977.24 | $1,949.84 |
Select Health Setting Facility Modifier None Typical Low $645.65 Median $933.25 Typical High $4,265.80 | Facility | None | $645.65 | $933.25 | $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 $562.34 Median $794.33 Typical High $1,230.27 | Professional | None | $562.34 | $794.33 | $1,230.27 |
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 $331.13 Median $354.81 Typical High $416.87 | Professional | 52 · Reduced service | $331.13 | $354.81 | $416.87 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $131.83 Median $141.25 Typical High $165.96 | Professional | 53 · Discontinued | $131.83 | $141.25 | $165.96 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $501.19 Median $524.81 Typical High $630.96 | Professional | 54 · Surgery only | $501.19 | $524.81 | $630.96 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $100.00 Median $104.71 Typical High $125.89 | Professional | 55 · Aftercare only | $100.00 | $104.71 | $125.89 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $66.07 Median $70.79 Typical High $83.18 | Professional | 56 · Pre-op care only | $66.07 | $70.79 | $83.18 |
Aetna Setting Professional Modifier 78 · Unplanned return to OR Typical Low $467.74 Median $489.78 Typical High $588.84 | Professional | 78 · Unplanned return to OR | $467.74 | $489.78 | $588.84 |
Where Nevada sits
The same service costs 4.9 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
$871
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.