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 $3,162.28 Typical High $7,244.36 | Facility | None | $776.25 | $3,162.28 | $7,244.36 |
Aetna Setting Professional Modifier None Typical Low $707.95 Median $741.31 Typical High $3,467.37 | Professional | None | $707.95 | $741.31 | $3,467.37 |
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 $794.33 Median $954.99 Typical High $1,412.54 | Professional | None | $794.33 | $954.99 | $1,412.54 |
Cigna Setting Facility Modifier None Typical Low $724.44 Median $2,137.96 Typical High $2,951.21 | Facility | None | $724.44 | $2,137.96 | $2,951.21 |
Cigna Setting Professional Modifier None Typical Low $549.54 Median $691.83 Typical High $1,047.13 | Professional | None | $549.54 | $691.83 | $1,047.13 |
Hometown Health Setting Professional Modifier None Typical Low $5.89 Median $870.96 Typical High $1,148.15 | Professional | None | $5.89 | $870.96 | $1,148.15 |
Hometown Health Setting Facility Modifier None Typical Low $2,041.74 Median $2,041.74 Typical High $2,041.74 | Facility | None | $2,041.74 | $2,041.74 | $2,041.74 |
Hometown Health Setting Professional Modifier None Typical Low $5.13 Median $5.13 Typical High $1,071.52 | Professional | None | $5.13 | $5.13 | $1,071.52 |
Select Health Setting Facility Modifier None Typical Low $724.44 Median $724.44 Typical High $4,265.80 | Facility | None | $724.44 | $724.44 | $4,265.80 |
Select Health Setting Professional Modifier None Typical Low $758.58 Median $758.58 Typical High $758.58 | Professional | None | $758.58 | $758.58 | $758.58 |
United Setting Facility Modifier None Typical Low $1,174.90 Median $1,698.24 Typical High $4,073.80 | Facility | None | $1,174.90 | $1,698.24 | $4,073.80 |
United Setting Professional Modifier None Typical Low $602.56 Median $794.33 Typical High $1,202.26 | Professional | None | $602.56 | $794.33 | $1,202.26 |
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 $354.81 Median $371.54 Typical High $389.05 | Professional | 52 · Reduced service | $354.81 | $371.54 | $389.05 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $141.25 Median $147.91 Typical High $154.88 | Professional | 53 · Discontinued | $141.25 | $147.91 | $154.88 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $537.03 Median $549.54 Typical High $575.44 | Professional | 54 · Surgery only | $537.03 | $549.54 | $575.44 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $107.15 Median $112.20 Typical High $117.49 | Professional | 55 · Aftercare only | $107.15 | $112.20 | $117.49 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $70.79 Median $74.13 Typical High $77.62 | Professional | 56 · Pre-op care only | $70.79 | $74.13 | $77.62 |
Aetna Setting Professional Modifier 78 · Unplanned return to OR Typical Low $501.19 Median $512.86 Typical High $537.03 | Professional | 78 · Unplanned return to OR | $501.19 | $512.86 | $537.03 |
Where Nevada sits
The same service costs 8.1 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· 28th of 51
$955
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.